Early Experience in Aortic Valve Reconstruction with Autologous Pericardium for Aortic Valve Insufficiency

Abstract

Objective: Several authors have reported good results with the use of autologous treated pericardium for aortic valve reconstruction with good results specially the current series of Ozaki, so we decided to start our learning curve in this type of surgery for its benefits and to avoid the cost and potential complications that may be resulted from aortic valve replacement.Methods: Between August 2013 and November 2015, 43 patients were scheduled for aortic valve reconstruction using gluataraldehyde treated autologous pericardium. They were isolated aortic lesions or associated with repairable mitral or mitral and tricuspid valve lesion (26 patients were pure aortic regurge, 8 patients were aortic regurge + mild to moderate stenosis, 5 patients were aortic valve lesion associated with mitral regurge and 4 patients were aortic lesions associated with mitral and tricuspid regurge). Their mean age was 30.4 ± 6.7 and male/female was 25/18. We used Gaspayran formula to fabricate new pericardial leaflet, all patients were evaluated by transesophygeal echo before discharging from the operating room.Results: 4 patients out of 43 patients have undergone aortic valve replacement (2 of them because of mitral valve repair failed and the other 2 because of thickened pericardium and adhesion) aortic valve reconstruction was done successfully in the remaining patients (39 patients).There were no hospital deaths, transthoracic echo before discharge from the hospital revealed no regurge and no significant pressure gradient, also follow up echo for a mean period 21.5 ± 6.9 months revealed stable aortic valve function with no significant pressure gradient or significant regurge. Conclusion:Aortic valve reconstruction with treated autologous pericardium is feasible with acceptable hemodynamic. The cornerstone of this surgery is perfect sizing and fabricating the new pericardial aortic leaflets and precise suturing methods.(n = Non-coronary cusp, r = right coronary cusp, l = left coronary cusp)

Неокуспідизація Аортального Клапана Власним Перикардом Із Використанням Набору Сайзерів І Відповідних Лекал – Безпосередні Результати

“…Слід зазначити, що вимірювання розмірів стулок для створення тристулкової анатомії в пацієнтів із моно-та двостулковим АК має технічні складнощі. У зв'язку з цим деякі автори уникають проведення неокуспідизації в пацієнтів з вадами моно-та двохстулкового клапана [25].…”