Patch-graft enlargement of the aortic root using autologous pericardium (long-term results)

In some clinical cases, mainly with severe aortic valve stenosis, there is a disproportion between the diameter of the aortic root and the adequate valve prosthesis for the patient. The resulting defect of the aorta requires a patch closure. The patch material mostly used is Dacron, but in our series autologous pericardium has been preferred. From 1970 to 1979 this procedure was performed in 28 out of 661 patients with aortic valve replacement (4.2%). Seven patients died postoperatively or during the follow-up period. In 1981 the surviving patients were restudied with particular reference to any complication resulting from the pericardial patch. The follow-up period was 15 months to 10 years with a mean of 4 years. Data of the postoperative reexaminations of 19 out of these 21 patients are available. No patient restudied demonstrated any sign of aortic aneurysmal dilatation or destruction, dissection, or perivalvular leakage in this particular area. Therefore autologous pericardium can be recommended as patch material to close a defect in the ascending aorta after aortic valve replacement.