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Aortic valve repair using aortic wall as leaflet patch material in children.

Dominic P Recco1,2, Lauren Marshall1, V Kandice Mah2,3

  • 1Department of Cardiac Surgery, Boston Children's Hospital, Boston, Mass.

JTCVS Techniques
|October 20, 2025
PubMed
Summary

Aortic wall patches show similar short-term outcomes to autologous pericardium for pediatric aortic valve repair. This living tissue may offer better long-term valve performance and durability.

Keywords:
aortic leaflet replacementaortic regurgitationaortic valve reinterventionaortic valve repaircongenital valve diseasepatch augmentation

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Biomaterials Science

Background:

  • Aortic valve repair (AVr) is effective in children with sufficient native tissue.
  • Patch augmentation is necessary for deficient aortic valve leaflets.
  • Autologous pericardium (AP) patches can calcify, leading to cusp immobility and high failure rates.

Purpose of the Study:

  • To assess the use of aortic wall (AW) as a leaflet patch material in pediatric AVr.
  • To compare the outcomes of AVr using AW patches versus AP patches.

Main Methods:

  • A retrospective study of 38 children undergoing AVr between January 2023 and July 2024.
  • Patients received either bicuspidization or other AVr techniques using AW (n=19) or AP (n=19) patches.
  • Primary endpoints included aortic valve reoperation and/or recurrent moderate or severe aortic regurgitation (AR).

Main Results:

  • Hospital stay, complications, and predischarge reoperations were similar between AW and AP groups.
  • At discharge, rates of moderate/severe AR were similar; however, the AW group had a lower incidence of trivial AR.
  • At a median follow-up of 10.2 months, no additional reoperations occurred in the AW group, compared to 3 in the AP group.

Conclusions:

  • Pediatric AVr using AW patches demonstrates comparable short-term outcomes to AP patches.
  • Aortic wall patches, as living autologous tissue, may offer superior valve performance and durability.
  • AW patches could expand treatment options for aortic valves previously considered unrepairable.