Reconstruction of atrioventricular valves with photo-oxidized bovine pericardium

Repair of complex valve pathological processes often requires the use of leaflet tissue or pericardium. The use of bovine photo-oxidized pericardium may be an alternative, a tissue less prone to calcification. The aim of this study is to evaluate the use of photo-oxidized bovine pericardial tissue in the reconstruction of atrioventricular valves in humans. Between July 2001 and September 2006, 21 patients with complex valve pathology underwent a reconstruction with photo-oxidized pericardium. The pericardial patch was used for the reconstruction of a tricuspid valve leaflet in two patients, the reconstruction of a mitral valve leaflet in six patients, the reconstruction of the tricuspid annulus in one patient and the reconstruction of the mitral annulus in 12 patients. The follow-up ranged from 13.9 to 43.2 months. There were five perioperative deaths. Four patients developed failure of the reconstruction, in one patient there was thinning and perforation of the pericardial patch without signs of infection or abrasion. The other patients were free from thromboembolism, endocarditis, hemorrhagic complications or echocardiographic signs of failure of the reconstruction. Photo-oxidized bovine pericardium is a versatile material for complex reconstruction of the atrioventricular valvular structures. Its durability should, however, be investigated in comparison with alternative tissues in a randomized trial.