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Aortic Valve Replacement with Single-Strip Autologous Pericardium
Ismail Dilawar1, Jusuf Rachmat1, Ito Puruhito2
1Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
The Thoracic and Cardiovascular Surgeon
|June 15, 2023
Summary
A novel aortic valve replacement using autologous pericardium shows promising short-term results. This technique offers an alternative to mechanical valves, improving patient outcomes and reducing the need for anticoagulants.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Biomaterials in Medicine
Background:
- Mechanical aortic valve replacement is standard but costly and requires lifelong anticoagulation.
- Associated risks include endocarditis and thromboembolic events.
- Autologous pericardium presents a potential alternative for aortic valve repair/replacement.
Purpose of the Study:
- To evaluate the short-term outcomes of a novel aortic valve replacement technique using autologous pericardium.
- To assess the feasibility and efficacy of single-strip autologous pericardium for aortic valve reconstruction.
Main Methods:
- Sixteen patients underwent aortic valve replacement with a single-strip autologous pericardium between April 2017 and April 2020.
- Outcomes measured at 6 months included left ventricular reverse remodeling (LVRR), 6-minute walk test (6MWT), and soluble suppression of tumorigenicity-2 (sST-2) levels.
- Surgical data including cross-clamp and cardiopulmonary bypass times were recorded.
Main Results:
- All 16 patients received the pericardial valve without conversion to mechanical valves.
- Significant improvement observed in 6-minute walk test distance (p=0.006) and a trend towards decreased sST-2 levels (p=0.098) at 6 months.
- One-year survival and freedom from reoperation were 100%; two patients showed left ventricular reverse remodeling (LVRR).
Conclusions:
- Aortic valve replacement with a single strip of autologous pericardium is a viable alternative to mechanical valves.
- The procedure demonstrated favorable short-term clinical and echocardiographic improvements.
- This technique offers a promising option for managing aortic valve disease, potentially reducing long-term complications.
