A Stentless Trileaflet Valve From a Sheet of Decellularized Porcine Small Intestinal Submucosa Jennifer K. White, MD, Arvind K. Agnihotri, MD, James.

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Presentation transcript:

A Stentless Trileaflet Valve From a Sheet of Decellularized Porcine Small Intestinal Submucosa Jennifer K. White, MD, Arvind K. Agnihotri, MD, James S. Titus, David F. Torchiana, MD The Annals of Thoracic Surgery Volume 80, Issue 2, Pages 704-707 (August 2005) DOI: 10.1016/j.athoracsur.2004.08.063 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Schematic of method of preparing valved conduit from a sheet of tissue. (A) Flat sheet of tissue (b = width, 20 mm; l = length, 62 mm). (B) Cylinder of tissue created by suturing the flat sheet along its width (a = cylinder diameter; b = height; c = incised portion, 15 mm; d = longitudinal incision, 5 mm). (C) Involution of flaps inside cylinder. (D-E) Creation of valve and leaflets by suturing tissue flaps to inner wall of cylinder. (F) Two-dimensional cuffs of tissue sutured to superior and inferior aspect of valve to create valved conduit. The Annals of Thoracic Surgery 2005 80, 704-707DOI: (10.1016/j.athoracsur.2004.08.063) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Photograph of valve construct derived from a sheet of single-ply porcine small intestinal submucosa using involution method. The Annals of Thoracic Surgery 2005 80, 704-707DOI: (10.1016/j.athoracsur.2004.08.063) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Trileaflet valve construct positioned in conduit surgically implanted in sheep pulmonary trunk. The Annals of Thoracic Surgery 2005 80, 704-707DOI: (10.1016/j.athoracsur.2004.08.063) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Catheter pullback across valve construct in sheep pulmonary trunk. (PA = pulmonary artery; RV = right ventricle.) The Annals of Thoracic Surgery 2005 80, 704-707DOI: (10.1016/j.athoracsur.2004.08.063) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Histology of valve leaflet depicting full-thickness impregnation of erythrocytes in porcine small intestinal submucosal tissue. (Hematoxylin & eosin stain, original magnification ×200.) The Annals of Thoracic Surgery 2005 80, 704-707DOI: (10.1016/j.athoracsur.2004.08.063) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Explanted valve construct in pulse duplicator. (Left) Closed position. (Right) Open position. The Annals of Thoracic Surgery 2005 80, 704-707DOI: (10.1016/j.athoracsur.2004.08.063) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions