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要求越来越高。特别是对先天性和获得性心脏病的需求增加。在人类，目前的心内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还没有建立起来。我们在几年前就建立了犬的体外循环技术。另一方面，犬获得性心脏病二尖瓣关闭不全(返流)的发生率随着年龄的增长而增加。本研究的目的是建立治疗犬二尖瓣关闭不全的二尖瓣置换术。目前，我们使用Denacl、R ex-313、肝素和鱼精蛋白处理的猪主动脉瓣制作了同种异体瓣膜，在体外循环下利用体外循环系统进行同种异体瓣膜置换术。因此，对移植瓣膜的处理有多种方法和解决方案。结果表明，其中一种二尖瓣置换术后，血液动力学性质良好，耐久性高，血栓栓塞率低，且无抗凝血，术后存活约3年。根据本实验研究结果，二尖瓣置换术将在兽医临床领域推广应用。

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.