| Stentless atrioventricular valve has physiologic hemodynamics. We constructed a stentless atrioventricular valve using a cryopreserved porcine mitral complex. To begin with its viability studies and exploration of surgical implanting technique, we studied effects of cryopreservation on porcine mitral endothelial viability and proteoglycan content change in cryopreserved porcine mitral leaflets. Moreover, Canine tricuspid valve replacement with stentless atrioventricular valve was carried out. The stentless valve function was evaluated via hemodynamic monitoring and intraoperative echocardiographic studies.1. Preparation, Preservation, and Surgical Technique Exploration of Stentless Atrioventricular ValveTo investigate the ultramicroscopic changes of cryopreserved porcine mitral valve and to explore the surgical implanting technique of this stentless artioventricular valve, porcine mitral valves were excised with two tips of the papillary muscles. They were cryopreserved following antibiotic disinfecting procedure. Transmission electron microscopic studies of the porcine mitral leaflets after one month cryopreservation were conducted. The tricuspid valves of in vitro porcine hearts were excised. Cryopreserved mitral homografts were implanted in such an "anti-anatomic" manner that the mitral homograft is orientated so as to position the mitral anterior leaflet at the level of the septum and the mitral posterior leaflet at the site of tricuspid anterior and posterior leaflets. Two papillary muscles were anchored onto the anterior right ventricular wall. Water was injected into the right ventricle to test competence of the stentless atrioventricular valve.Observations in the transmission electron microscopy included intact and confluent endothelium on the valve surface and morphologically unaltered fibroblasts in the leaflet matrix. The collagen bundles were well aligned. No irreversible injury was observed. The stentless atrioventicular valves revealed complete patency in...
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