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Midterm results after aortic valve neocuspidization
Anatol Prinzing1, Johannes Boehm1, Melchior Burri1
1Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Munich, Germany.
JTCVS Techniques
|June 20, 2024
Summary
Aortic valve neocuspidization shows excellent midterm durability and survival. This procedure maintains low pressure gradients, with low rates of structural valve degeneration and bioprosthetic valve failure, making it a viable option for aortic valve disease.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Biomaterials in Medicine
Background:
- Aortic valve neocuspidization using autologous pericardium is an emerging surgical technique for aortic valve disease.
- Midterm durability and valve-related events following this procedure require further investigation.
Purpose of the Study:
- To evaluate the midterm durability and clinical outcomes of aortic valve neocuspidization with autologous pericardium.
- To assess valve-related events, including structural valve deterioration and reoperation rates.
Main Methods:
- A cohort of 162 patients undergoing aortic valve neocuspidization between 2016 and 2021 was retrospectively analyzed.
- Transthoracic echocardiography was performed preoperatively, at discharge, and annually postoperatively.
- Data on survival, reoperation, structural valve deterioration, and hemodynamic performance were collected and analyzed.
Main Results:
- Mean follow-up was 3.5 years. At 5 years, cumulative incidences of moderate/severe structural valve deterioration were 9.82% ± 3.87%, and bioprosthetic valve failure was 12.1% ± 4.12%.
- Survival at 5 years was 97.3% ± 1.4%, with freedom from reoperation at 91.3% ± 2.4%.
- Low pressure gradients were maintained postoperatively and during follow-up.
Conclusions:
- Aortic valve neocuspidization demonstrates favorable midterm hemodynamic performance and excellent survival rates.
- Low rates of structural valve degeneration and bioprosthetic valve failure suggest good durability.
- Endocarditis was the primary indication for reoperation, highlighting the importance of infection prevention.
