Aortic valve repair with autologous pericardial patch☆

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Abstract

Introduction:

Isolated aortic valve repair (AVR) has been gaining increasing interest in recent times. Results of isolated aortic valve repair have been reported to be variable. Various techniques have been utilized. We analyzed our experience with isolated valve repair using autologous pericardial patch plasty and compared the results to an age-matched collective with aortic valve repair without the use of additional material.

Methods:

Between January 1997 and June 2005, pericardial patch plasty of the aortic valve was performed in 42 patients (PATCH). During the same period, 42 patients after AVR without the use of additional material were age matched (NO-PATCH). Mean age in both groups was 52 years with a majority of male patients (PATCH ratio, 3.7:1; NO-PATCH ratio, 5:1). Valve anatomy was similar in both groups. All patients were followed by echocardiography for a cumulative follow-up of 2341 patient months (mean 28 ± 23 months).

Results:

No patient died in the hospital in neither group. The average systolic gradient was 5.9 ± 2.2 mmHg in PATCH and 4.8 ± 2.1 mmHg in NO-PATCH; p = 0.17). Freedom from aortic regurgitation ≥II° was 87.8% in PATCH and 95.0% in NO-PATCH after 5 years (p = 0.21). Freedom from reoperation was 97.6% in PATCH and 97.4% in NO-PATCH (p = 0.96).

Conclusions:

Aortic regurgitation can be treated effectively by aortic valve repair using pericardial patch plasty. The functional results are satisfactory. With the application of this technique also more complex pathologies of the aortic valve can be addressed adequately thus extending the concept of valve preservation in patients with aortic regurgitation.

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