Aortic valve replacement with freehand autologous pericardium

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Biomaterials in Medicine

Background:

• Aortic valve disease is a significant cause of morbidity and mortality.
• Autologous pericardium presents a potential alternative for aortic valve replacement, particularly in younger patients.
• Durability and long-term outcomes of pericardial aortic valves require further investigation.

Purpose of the Study:

• To evaluate the safety and efficacy of glutaraldehyde-treated autologous pericardium for aortic valve replacement.
• To assess early and mid-term clinical outcomes, including survival, reoperation rates, and valve function.
• To analyze echocardiographic parameters and complications associated with this technique.

Main Methods:

• Fifty-one patients underwent aortic valve replacement using glutaraldehyde-treated autologous pericardium.
• Patients presented with various aortic valve pathologies including regurgitation, stenosis, and mixed disease.
• Follow-up included clinical assessment, echocardiography, and analysis of adverse events and reoperations.

Main Results:

• No hospital mortality; two late deaths occurred. Three patients required reoperation due to valve failure (infective endocarditis, commissural tear).
• Actuarial survival was 84.53% at 60 months; freedom from aortic reconstruction failure was 83.83%.
• Echocardiography showed acceptable mean gradients and minimal regurgitation, with no detected thromboembolic events.

Conclusions:

• Glutaraldehyde-treated autologous pericardium is a viable option for aortic valve replacement, demonstrating encouraging early outcomes.
• The technique shows promise for young patients, with good hemodynamic function and acceptable reoperation rates.
• Long-term follow-up is essential to fully establish the durability and benefits of this pericardial valve prosthesis.