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Treated bovine and autologous pericardium for aortic valve reconstruction
C M Duran1, B Gometza, M Shahid
1International Heart Institute of Montana Foundation, Missoula 59802, USA. duran@montana.com
Background:
To determine the differences in clinical behavior of bovine versus autologous pericardium, all consecutive patients undergoing aortic valve reconstruction were reviewed.
Methods:
Between October 1988 and December 1995, 91 patients (mean age 30 years) underwent reconstruction with bovine (n = 27) or autologous (n = 64) pericardium.
Results:
There were 2 hospital deaths, 5 late deaths, and no embolic events. Dysfunction of the aortic reconstruction required reoperation in 6 bovine (infection 1, fibrocalcific 5) and in 5 autologous (infection 3, annulus dilatation 1, commissural tear 1). Actuarial survival and freedom from structural deterioration at 8 years were 82.2%+/-9.6% and 76.2%+/-10.7% for bovine and 91.05%+/-3.96% and 96.8%+/-2.25% for autologous pericardium, respectively. The last Doppler echocardiographic study showed a mean regurgitation (1 to 4+) and gradient in the bovine pericardium of 1.25+/-and 20.7 mm Hg and in the autologous pericardium of 1+ and 7.7 mm Hg.
Conclusions:
Aortic valve reconstruction with pericardium can be safely performed with low thromboembolic rate. At 8 years follow up, there is a difference in favor of the autologous pericardium.