Autologous pericardial aortic valve reconstruction: early results and comparison with mechanical valve replacement

Abstract

Introduction

Autologous pericardial aortic valve reconstruction is an attractive option compared with prosthetic valve replacement due to the absence of anticoagulation, lower pressure gradient across the valve and excellent valve haemodynamics.

Objective

We wanted to share the early results of autologous pericardial aortic valve reconstruction from our centre. The outcomes were compared with that of mechanical valve replacement.

Materials and methods

Between August 2016 to July 2018, 20 patients underwent autologous aortic valve reconstruction as per the techniques described by Ozaki et al. The surgery was done for aortic stenosis or regurgitation or a combination of both. All the surgeries were done by a single experienced surgeon. The results were compared to that of mechanical valve replacement. A comprehensive echocardiographic evaluation was done pre-discharge and at 6 months after surgery. The postoperative echocardiographic parameters that were evaluated include aortic valve pressure gradient, aortic valve orifice area, ejection fraction, left ventricular diameters etc. All the parameters were measured by a single expert. Other perioperative parameters were also evaluated like cardiopulmonary bypass and cross-clamp time, need for anticoagulation etc. Statistical analysis was done using chi-square test/Mann-Whitney U test/independent sample t test.

Results

Autologous pericardial aortic valve reconstruction had several favourable results including lower aortic valve pressure gradient, bigger aortic valve orifice area etc. None of the patients required anticoagulation. There were no conversions to prosthetic valve replacement or reinterventions in the follow-up period.

Conclusion

Autologous pericardial aortic valve reconstruction is a feasible alternative to prosthetic valve replacement with several advantages.

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Correspondence to Rakesh Naik Lachma.

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We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal. All authors have approved the manuscript and agreed with submission to Indian Journal of Thoracic and Cardiovascular Surgery.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Vijayan, J., Lachma, R.N., Mohan Rao, P.S. et al. Autologous pericardial aortic valve reconstruction: early results and comparison with mechanical valve replacement. Indian J Thorac Cardiovasc Surg 36, 186–192 (2020). https://doi.org/10.1007/s12055-019-00855-6

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Keywords

  • Autologous pericardium
  • Aortic valve reconstruction
  • Left ventricular mass