|Truly stentless autologous pericardial aortic valve replacement: an alternative to standard aortic valve replacement.|
|PMID: 20965520 Owner: NLM Status: MEDLINE|
|OBJECTIVE: The aim of this study was to determine the feasibility and durability of truly stentless aortic valve replacement using autologous pericardium sutured directly onto the aortic wall.
METHODS: Eleven patients (mean age, 55.9 years) requiring aortic valve replacement were recruited. A circular piece of pericardium about 8 cm in diameter was harvested and treated in 0.6% glutaraldehyde for 10 minutes. The aortic valve was excised and, with the use of specially designed instruments (CardioMend LLC, Santa Barbara, Calif), the sinotubular junction was sized and the pericardium was tailored to the required size and shape and then sutured directly onto the aortic wall. The reconstructed valve was assessed directly and by echocardiography at the end of the operation; it was assessed by echocardiography and cardiac magnetic resonance imaging at 6 months and yearly. Computed tomographic scan of the aortic valve to assess for valve calcification was performed at last follow-up.
RESULTS: Hospital mortality was 0%. Mean follow-up was 6.5 years (range, 5.3-7.5 years). Freedom from structural valve deterioration, thromboembolism, endocarditis and reoperation was 100%, 100%, 72.7%, and 63.6%, respectively. There were 4 reoperations at 4, 13, 15, and 46 months, 3 of them owing to endocarditis and 1 owing to technical failure noted at the time of surgery. The remaining 7 patients are alive and well with a mean New York Heart Association class of 1.3 and normally functioning aortic valves with no calcification.
CONCLUSIONS: Truly stentless aortic valve replacement using autologous pericardium sutured directly onto the aortic wall is safe and feasible and has excellent durability up to 7.5 years with no calcification.
|K M John Chan; Shelley Rahman-Haley; Tarun K Mittal; Jemyrr A Gavino; Gilles D Dreyfus|
|Type: Journal Article Date: 2010-10-20|
|Title: The Journal of thoracic and cardiovascular surgery Volume: 141 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2011 Jan|
|Created Date: 2010-12-20 Completed Date: 2011-01-13 Revised Date: -|
Medline Journal Info:
|Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States|
|Languages: eng Pagination: 276-83 Citation Subset: AIM; IM|
|Copyright © 2011 The American Association for Thoracic Surgery. All rights reserved.|
|Department of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Foundation Trust, Royal Brompton Hospital, London, United Kingdom. KMJChan@btopenworld.com|
|APA/MLA Format Download EndNote Download BibTex|
Aorta / surgery
Aortic Valve / radiography, surgery*, ultrasonography
Aortic Valve Insufficiency / diagnosis, ultrasonography*
Aortic Valve Stenosis / diagnosis, surgery*
Calcinosis / diagnosis, etiology
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects, instrumentation*
Magnetic Resonance Imaging
Pericardium / transplantation*
Tissue Fixation / methods
Tissue and Organ Harvesting / methods
Tomography, X-Ray Computed
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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