Autologous pericardial aortic valve reconstruction: early results and comparison with mechanical valve replacement

Autologous pericardial aortic valve reconstruction is an attractive option compared with prosthetic valve replacement due to the absence of anticoagulation, lower pressure gradient across the valve and excellent valve haemodynamics.

We wanted to share the early results of autologous pericardial aortic valve reconstruction from our centre. The outcomes were compared with that of mechanical valve replacement.

Between August 2016 to July 2018, 20 patients underwent autologous aortic valve reconstruction as per the techniques described by Ozaki et al. The surgery was done for aortic stenosis or regurgitation or a combination of both. All the surgeries were done by a single experienced surgeon. The results were compared to that of mechanical valve replacement. A comprehensive echocardiographic evaluation was done pre-discharge and at 6 months after surgery. The postoperative echocardiographic parameters that were evaluated include aortic valve pressure gradient, aortic valve orifice area, ejection fraction, left ventricular diameters etc. All the parameters were measured by a single expert. Other perioperative parameters were also evaluated like cardiopulmonary bypass and cross-clamp time, need for anticoagulation etc. Statistical analysis was done using chi-square test/Mann-Whitney U test/independent sample t test.

Autologous pericardial aortic valve reconstruction had several favourable results including lower aortic valve pressure gradient, bigger aortic valve orifice area etc. None of the patients required anticoagulation. There were no conversions to prosthetic valve replacement or reinterventions in the follow-up period.

Autologous pericardial aortic valve reconstruction is a feasible alternative to prosthetic valve replacement with several advantages.