We have lost our way in aortic valve surgery! We have made a lot of valves but we have never followed in general the principals dictated by nature. There are only few surgeons in the world who pay attention to the very complex physiology of the aortic valve apparatus. As a result we are trying to outperform nature! Wouldn`t it be logical to conform to physiology? The mitral valve repair is a method of choice for the majority of the cases. However in some cases the valve repair is not possible and its replacement is not desirable troublesome and even dangerous. Total autologous reconstruction of the mitral valve may be a very helpful option for such cases. The “ideal” valve should be: not rigid allowing for the continuous movements of all heart structures; non-thrombogenic requiring no permanent anticoagulation; hemodynamically sound absent of significant trans-valvular gradients during exercise; durable which presently means capable of more than 20 years of normal function; easily surgically implantable and economically affordable. My valves do meet all these requirements!
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