A Comparative Study of Aortic Valve Neocuspidization Techniques: Formula vs. Template Methods of Neocusp Formation

Area of Science:

• Cardiovascular Surgery
• Surgical Innovation
• Biomedical Engineering

Background:

• The established template method (TM) for aortic valve neocuspidization (AVNeo) requires specialized instruments, increasing complexity and cost.
• A novel formula method (FM) has been developed, utilizing aortic valve diameter (AV-D) to determine neocusp dimensions without templates.

Purpose of the Study:

• To compare the clinical outcomes of the novel formula method (FM) against the established template method (TM) in patients undergoing aortic valve neocuspidization (AVNeo).

Main Methods:

• A retrospective and prospective study involving 31 patients undergoing isolated AVNeo between January 2019 and December 2022.
• Patients were divided into FM (n=17) and TM (n=14) groups.
• Primary endpoints included major adverse valve-related events; secondary endpoints assessed hemodynamic performance and functional class.

Main Results:

• Both FM and TM demonstrated comparable intraoperative and early postoperative outcomes, with similar cardiopulmonary bypass times, ischemia times, and blood loss.
• Mid-term hemodynamic performance showed no significant differences between groups, including peak pressure gradients and aortic valve area.
• Both techniques resulted in substantial reverse left ventricular remodeling, with no significant differences in freedom from reoperation or adverse events.

Conclusions:

• The formula method (FM) for AVNeo provides a cost-effective and practical alternative to the template method (TM), yielding similar clinical outcomes.
• FM has the potential to enhance the accessibility of AVNeo, particularly in resource-limited healthcare settings.
• Further research with larger patient cohorts and extended follow-up is warranted to confirm the long-term durability and benefits of the FM.