| abstract |
A graft-support for homograft and heterograft tissue valve implantation comprising a ring base, two struts extending from one side of the ring base and generally parallel to its axis, and a fabric layer covering the entire surface of the ring and struts. The fabric layer has a thickened portion at the apex of each strut, a second thickened portion along the top edge of the ring and a third thickened portion extending circumferentially of the ring. These thickened portions provide means for suturing the graft-support to the valve tissue and to the host heart, respectively. In one very advantageous embodiment, the ring is generally oblong in shape having a long diameter and a short diameter and the struts are disposed opposite to each other, one at each end of the oblong ring, i.e., at each end of the long diameter thereof or on a line parallel thereto. In effecting the transplantation, animal tissue, such as fascia lata derived from the patient, is wrapped around the upstanding struts and joined at the ends by suturing to form a closed ring of tissue, and forming also two cusps thereof supported by the struts. Each cusp is then sutured at its base to the covering at the top surface of the ring and along the sides of the struts, and a pledget of the fabric or suture is affixed around the top of the strut, the fabric thereover and the tissue to ensure coaptation of the cusps. The tissue, especially fascia lata from the patient, can also be extended to cover the side of the third thickened portion, or sewing ring, which is exposed to the ventricle so that, when the valve is emplaced, the entire ventricular surface is covered with autologous tissue. The device is then placed in the mitral valve position with struts extending into the ventricle and the host heart is sutured to the peripheral thickened flange, i.e., the third thickened portion. |