Aortic Valve Reconstruction: Midterm Results from Central Chest Hospital

Chotivatanapong, Taweesak; Chaiseri, Praditchai; Kasemsarn, Choosak; Yotthasurodom, Chaiwut; Sungkahapong, Vibhan; Cholitkul, Sireethorn

doi:10.1177/021849230000800308

Cited by 4 publications

(6 citation statements)

References 9 publications

(13 reference statements)

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“…It is recommended that this technique should be tested in animal experiments with a view to clinical application in the future, since the good durability of autopericardium has been established. 10,11 It is hoped that this technique might be a good alternative to prosthetic MV replacement, especially in patients who are young, those desiring pregnancy, and in cases where long-term anticoagulation is contraindicated. We intend to conduct studies in animals to evaluate the function of the reconstructed valves using echocardiography, and we look forward to collaborating with other enthusiasts in this endeavor.…”

Section: Resultsmentioning

confidence: 99%

“…This is of special interest in patients who are young, those desiring pregnancy, those who live in remote areas with problems of poor drug compliance, and in cases where long-term anticoagulation is contraindicated. 11 So far, there have been no reports of total reconstruction of the MV with autopericardium. The two main essential factors to be considered in this respect are the need for a standard surgical technique to ensure a correct, reproducible, and safe result, and the long-term durability of the selected material.…”

Section: Discussionmentioning

confidence: 99%

“…Different methods of total reconstruction of the aortic valve with autologous pericardium have been described, with good results. 10,11 Our previous experimental studies were dedicated to this. 12,13 Autopericardium, because of its ready availability, ease of handling, and low cost, has been used regularly since the early days of cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

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Total Reconstruction of the Mitral Valve with Autopericardium: Anatomical Study

Gasparyan

Galstyan

2002

Asian Cardiovasc Thorac Ann

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Mitral valve repair has several advantages over prosthetic valve replacement. A new technique of total reconstruction of the mitral valve with autologous pericardium is described. The native mitral valve leaflets and chordae were excised from 10 human cadaver hearts, in the same way as for prosthetic valve replacement. The dimensions of the physiologically normal mitral valve were used to calculate the parameters for tailoring a corresponding new valve. Autologous pericardium was fixed in 0.625% glutaraldehyde solution for 10 minutes. The calculated parameters of the mitral valve were marked on the pericardium. The new valve was fashioned and inserted in the native valve position. Hydraulic probes showed good competence in all 10 reconstructed mitral valves. This method might be a good alternative to prosthetic valve replacement.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Total Reconstruction of the Mitral Valve with Autopericardium: Anatomical Study

Gasparyan

Galstyan

2002

Asian Cardiovasc Thorac Ann

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“…The factors that were responsible for recurrent aortic regurgitation in all these patients were thickening of the leaflet extension and rolling of the free edge of the pericardial patches, findings during definitive aortic valve reoperation. Chotivatanapong et al reported that in their series the most common finding after aortic valve repair was progressive thickening and retraction of the native aortic leaflet and pericardial patch leading to moderate to severe aortic regurgitation 13 .…”

Section: Discussionmentioning

confidence: 97%

Aortic valve repair with pericardial leaflet extension for aortic valve insufficiency

Bendre

Starr

2002

Indian J Thorac Cardiovasc Surg

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IntroductionThe surgical correction of aortic insufficiency in children and young adults remains a challenge. Homograft replacement and the Ross procedure represent the standard approach with predictable but not perfect results. Reparative procedures may provide a reasonable alternative in some clinical and social settings. The purpose of this report is to provide the intermediate results in which leaflet extension with autologous glutaraldehyde preserved pericardium is utilized. MethodsOf 60 patients that had aortic valve repair predominantly for aortic regurgitation from 1990 to 1999, 16 patients had aortic regurgitation with deficient leaflet tissues so that repair was performed with pericardial leaflet extension. There were 11 male (69%) and 5 female (31%) patients. The mean patient age was 26.6 years, range 1.6 -75.5 years. Three patients had previous aortic commissurotomy and 1 patient had repair of aortic coarctation. Preoperatively, 2 patients (13%) were in NYHA class I, 12 patients (75%) were in NYHA class II and 2 patients (13%) were in NYHA class III.Of the 16 patients, 6 patients (38%) had a bicuspid aortic valve and 10 patients (63%) had a tricuspid aortic valve. None of the patients had mild aortic insufficiency. Indications for surgery were moderate aortic valve insufficiency in 8 patients (50%) and severe aortic insufficiency in 8 patients (50%). One patient had concomitant mitral valve replacement and Abstract Background: This article presents our intermediate term results of pericardial leaflet extension used in various complex pathologies of the aortic valve leading to aortic regurgitation.Methods: Sixteen patients had aortic insufficiency/regurgitation with deficient leaflet tissues so that repair was performed with pericardial leaflet extension. The mean patient age was 26.6 years and 69% were male. Two patients (13%) were in NYHA class I, 12 patients (75%) were in class II and 2 patients (13%) were in class III preoperatively. Six patients (38%) had a bicuspid aortic valve and 10 patients (63%) had a tricuspid aortic valve. Eight patients (50%) had moderate and 8 patients (50%) had severe aortic insufficiency (AI) preoperatively. Two patients (13%) had associated cardiac procedures at the time of aortic repair.Results: There were no operative deaths but 3 patients died in the late postoperative period. Five patients underwent subsequent aortic valve replacement or a Ross procedure at re-operation. The most common finding during re-operation was thickening of the leaflet extension or rolling in of the edges of the leaflet extension. Freedom from aortic valve re-operation at five years postoperation was 68% (standard error 14). Late follow-up revealed that 9 patients (56%) were in NYHA class I and 7 patients (44%) were in class II. Ten (63%) patients had mild AI and 6 patients (37%) had moderate AI at most recent follow-up.Conclusions: Absence of hospital mortality, freedom from embolic events and echocardiography evidence of immediate competency of the valve are the reliable indicators of thi...

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“…7 Our previous study confirmed the encouraging midterm results of this technique. 8 It was found that the autologous pericardial valve could function satisfactorily, even in a highly stressed area such as the aortic valve position. Incorporation of valve cusps into the simple pericardial tube for RVOT reconstruction should result in an improved hemodynamic effect, provided the conduit functions satisfactorily without significant stenosis or regurgitation.…”

Section: Discussionmentioning

confidence: 99%

Autologous Pericardial Valved Conduit for the Ross Operation

Chotivatanapong

Kasemsarn²,

Yosthasurodom³

et al. 2005

Asian Cardiovasc Thorac Ann

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The feasibility and function of autologous pericardial valved conduit for right ventricular outflow tract reconstruction in the Ross operation were assessed. Between June 1997 and April 2002, 31 patients underwent this procedure at our institution; one was lost to follow-up. The other 26 males and 4 females were aged 17 to 60 years (mean, 36.6 years). Causes of aortic valve disease were infective endocarditis in 26 and rheumatic valve disease in 4. Mean follow-up was 16.7 months (range, 1-58 months). Preoperatively, 9 patients were in functional class II, 19 in class III, and 2 in class IV. Concomitant procedures included coronary artery bypass (1), mitral valve replacement (6), tricuspid valve replacement (1), and ventricular septal defect closure (1). Mean aortic crossclamp time was 199.4 min. There were 4 (13.3%) hospital deaths and no late death. Mean postoperative functional class was 1.17 with +0.36 aortic regurgitation, a peak gradient of 21.9 mm Hg (range, 6-59 mm Hg) across the conduit, and grade +0.96 pulmonary regurgitation. No conduit-related complication was detected. Use of autologous valved conduit for the Ross operation is feasible. Long-term follow-up is mandatory to assess durability.

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Aortic Valve Reconstruction: Midterm Results from Central Chest Hospital

Abstract: From September 1994 to September 1999 patients underwent successful aortic valve reconstruction. Four were lost to follow-up, there were 2 early and 2 late deaths. The remaining 35 males and 11 females (mean age, 39.

Cited by 4 publications

References 9 publications

Total Reconstruction of the Mitral Valve with Autopericardium: Anatomical Study

Total Reconstruction of the Mitral Valve with Autopericardium: Anatomical Study

Aortic valve repair with pericardial leaflet extension for aortic valve insufficiency

Autologous Pericardial Valved Conduit for the Ross Operation

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