Long-term results of aortomitral fibrous body reconstruction with double-valve replacement

This study aims to evaluate the early and long-term outcome of aortomitral fibrous body reconstruction with bovine pericardium in double-valve replacement.

Between January 1997 and December 2010, 30 consecutive patients (20 male patients) underwent aortomitral fibrous body reconstruction with double-valve replacement. Mean age was 52 ± 15 years (range, 9 to 77 years). The operative indications were infective endocarditis (IE) for 22 patients, small annuli for 5, and fragile annuli for 3. Bovine pericardium was used for all patients. Twelve patients (40%) needed an emergency operation for cardiogenic shock or septic emboli. The mean follow-up was 50.6 ± 43.5 months (range, 0 to 136 months).

There were 2 early (6.7%) and 5 late (16.7%) deaths. Early complications included bleeding in 6 patients, acute renal failure in 4, complete heart block in 3, and early reoperation due to paravalvular leakage in 1. Three patients with previous prosthetic valve endocarditis underwent late reoperations; specifically, redo valve replacements for 2 patients and heart transplantation for the other. Late dehiscence of prosthetic valve occurred in 1 patient with Behçet disease. In the IE patients, freedom from reoperation rate at 1 and 5 years was 95.5% and 84.8%, respectively, and the freedom from IE rate at 1 and 5 years was 94.7%. There was no statistical difference in overall survival rates between the patients with and without IE (p = 0.766).

The early and long-term results of aortomitral fibrous body reconstruction with double-valve replacement are promising, and bovine pericardium appears to have strong durability.