Aortic valve repair with patch in non-rheumatic disease: indication, techniques and durability†

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Biomaterials in Medicine

Background:

• Non-rheumatic aortic valve disease necessitates effective repair strategies.
• Biological patches offer a reconstructive approach for aortic valve (AV) repair.
• Understanding long-term outcomes is crucial for patient management.

Purpose of the Study:

• To analyze the long-term outcomes of aortic valve (AV) repair using biological patches in patients with non-rheumatic valve disease.
• To evaluate the safety, efficacy, and durability of this repair technique.

Main Methods:

• A cohort of 57 patients with non-rheumatic AV disease underwent cusp restoration using patches between 1995 and 2011.
• Various biological materials (autologous pericardium, bovine pericardium, etc.) were used for patching.
• Repair techniques included perforation, commissural defect, raphe repair, and cusp extension.
• Echocardiographic and clinical follow-up was 98% complete with a mean follow-up of 72 months.

Main Results:

• No hospital mortality was observed.
• At 8 years, overall survival was 90%, and freedom from valve-related death was 96%.
• Late reoperation was required in 16% of patients for aortic regurgitation or stenosis, with no mortality.
• Freedom from reoperation was 75% at 8 years, with excellent outcomes for perforation repair in tricuspid valves.

Conclusions:

• Aortic valve repair with biological patches is a feasible and safe procedure for diverse etiologies.
• Medium-term durability is acceptable, particularly for perforation repair in tricuspid valve morphology.
• Bovine pericardium serves as a viable alternative to autologous pericardium.