Mitral valve replacement with stored inverted pulmonary homograft valve.

The fate is described of 11 patients who had a stored pulmonary valve homograft mounted on a frame or in a Dacron jacket used for mitral valve replacement. Mitral regurgitation due to holes in the attenuated cusps occurred in nine by one year, requiring re-operation or causing death. Only one patient remains well with moderate mitral regurgitation after two years. Since January 1967, 118 patients have had mitral valve replacement with a preserved cadaver semilunar homograft valve mounted in a jacket or frame (Murray, Roschlau, and Lougheed, 1956; Heimbecker et al., 1962). In all except 11 patients the aortic valve was used. However, in the 11 patients in whom an inverted pulmonary valve was used (Lower, Stofer, and Shumway, 1961) the clinical course has been different. The purpose of this report is to draw attention to the problems and discourage the use of this form of mitral valve replacement.