New sutureless ‘atrial- mitral-valve prosthesis’ for minimally invasive mitral valve therapy

Incompetence is the most relevant dysfunction of the mitral valve. Surgical replacement and reconstruction is the treatment of choice whereas trans-catheter replacement or repair of mitral valve regurgitation proved demanding. We aimed for a new sutureless approach to anchor a biological heart valve in the mitral position without major surgery by inserting a valve-carrying hollow body into the left atrium.A mould representing the porcine left atrium from the pulmonary veins as far as the mitral valve was created. A superelastic Nitinol-skeleton was sutured onto a warp knitted tubular bifurcation of polyvinylidene fluoride (PVDF) multifilaments fitting the mould. This new self-expandable composite-material hollow body customized to the porcine anatomy was equipped with a commercially available biological heart valve. The functionality of this prosthesis was investigated in a circulatory mock loop simulator and the overall properties were examined in an open animal operation. The left atrium was incised and...