Clinical Study and Developement of Allograft Mitral Valve with Durability and Non-thrombosis for canine valve Replacement(2003)

近年来，对小动物心脏直视手术的需求不断增加。特别是对先天性、后天性心脏病的需求增加。在人类，目前的心脏直视手术技术包括使用人工心肺机建立体外循环。但是，兽医领域的体外循环技术尚未建立。几年前，我们在狗身上建立了体外循环技术。另一方面，获得性心脏病的犬二尖瓣功能不全（反流）的发病率随着年龄的增长而增加。因此，患者提出了根治性手术的要求。本研究的目的是建立二尖瓣置换术治疗犬二尖瓣不全的技术。迄今为止，我们以猪主动脉瓣为材料，经Denacl^R EX-313、肝素和鱼精蛋白处理制成同种异体瓣膜。同种异体瓣膜置换术是在体外循环下使用体外循环系统进行的。手术程序已建立，但瓣膜耐久性较弱。因此，同种异体移植瓣膜的处理方法和解决方案多种多样。其中一种瓣膜经地那考和谷戊醛处理后具有良好的血流动力学特性，耐久性高，且无抗凝的血栓栓塞率低。术后行二尖瓣置换术的犬存活约3年。在未来，作为本实验研究的结果，二尖瓣置换术治疗犬二尖瓣功能不全将在兽医临床领域得到应用。

Recently, requirement of the the open heart surgery in small animals are on the increase. Especilly, the requirement increase on the congenital,and acquired heart diseases.In humans, current technique in open heart surgery involve establishing extracorporeal circulation using an artificial heart-lung machine. But, the techniques of cardiopulmonary bypass system in veterinary domain had not established.We established the technique of extracorporeal circulation in dogs on several years ago.The other side, the incidence of canine mitral insufficiency (regurgitation) of acquired heart diseases is increasing with ageing. Therefore, requirement of the radical surgery is advanced by client.The purpose of this study is establishment the technique of mitral valve replacement for canine mitral insufficiency.Until now, we made allograft valve by pig's aortic valve which were treated by Denacl^R EX-313, Heparin and Protamine.The allograft valve replacement was done under the extracorporeal circulation using a cardiopulmonary bypass system.The surgical procedure was established, but the valve durability was weakly. Therefore, the allograft valve were treated by several kinds of methods and solutions. As the result, One type of these valves which were treated by Denacol and glutalaldehydes had good hemodynamic properties, high durability and in addition had low rates of thromboembolism without anticoagulation.After operation, these dogs which were done mitral valve replacement survived for about 3 years.In the future, as the result of this experimental study, mitral valve replacement for mitral insufficiency in dogs will be done in veterinary clinical field.