Acta Vet. Brno 2008, 77: 89-95

Transplantation of Mitral Allograft into the Tricuspid Position - a Sheep Experimental Model

A. Mokráček1, J. Hlubocký2, J. Burkert2, J. Vojáček2, M. Šulda1, M. Vambera1, J. Kursa3, V. Kroupová3, P. Kobylka4, J. Špatenka2

1Cardiac Surgery Department, Regional Hospital České Budějovice Inc.
2Transplant Centre, University Hospital Motol, Prague
3University of South Bohemia České Budějovice, Faculty of Agriculture, Department of Anatomy and Physiology of Farm Animals
4Institute of Hematology and Blood Transfusion, Prague

Received January 22, 2007
Accepted February 14, 2008

Our research was focused on finding the optimal technique of cryopreserved mitral allograft implantation into the tricuspid valve position in a sheep experiment. We prepared 20 cryopreserved mitral valve allografts preoperatively. These were implanted into the tricuspid position in 20 sheep via right thoracotomy, using extracorporeal circulation with cardioplegic heart arrest. We consider the transventricular papillary muscle fixation to be the best technique for obtaining optimal allograft geometry and long-term durability. We evaluated the valve function by epicardial echo before and after implantation, respectively. The findings were confirmed by haemodynamic measurements as well. It was proved that mitral allografts, harvested, processed, and stored according to the Cardiovascular Tissue Bank Protocol remained mechanically strong enough for implantation into the tricuspid position. It was demonstrated that the mitral allograft transplantation into the tricuspid position is feasible. The immediate postoperative haemodynamic performance was excellent in all animals. The mid-term results are currently being evaluated - prior to the possible application of the technique in humans at our institutions.