Partial mitral valve replacement with a mitral homograft in subacute endocarditis.

In a case of subacute endocarditis, the diseased parts of the mitral valve were replaced by the corresponding parts of a mitral valve homograft. This technique was studied experimentally in animals in the sixties and seventies, but was never performed clinically on a large scale in humans. By preserving a functional papillary muscle and chordae tendinae complex, ventricular function is more efficient than in the case of replacement of the valve by a prosthesis. The absence of any prosthetic material in an infected area also decreases the possibility of reinfection. In performing this type of operation, surgical pit falls such as fistulas at the region of the annulus, dehiscence of papillary muscle, or rupture of the chordae tendinae have to be avoided. Surgeons have to be supplied with high-quality homograft valves of different sizes to obtain optimal hemodynamic results.