Bovine Pericardial Patch Augmentation of One Insufficient Aortic Valve Cusp with Twenty-three-year Positive Clinical Follow-up Independent of the Patch Degeneration

Abstract

Scientific progress shall ultimately boost the current acceptance level for conservative aortic valve surgery. The present text aimed to report the 23-year long-term follow-up of one patient operated with bovine pericardium cusp extension. Growing confidence in the efficacy of the operation will allow a more expeditious indication for surgical treatment, as is already the case in mitral valve repair. This change of attitude will certainly make it possible for patients to be sent for operation in mild aortic valve regurgitation. The present report reinforces the concept and highlights the impression that the aortic valvoplasty, independent of the progressive bovine pericardium degeneration, may positively change the natural history of the aortic valve insufficiency.

Aortic Valve Replacement with Bovine Pericardium in Patients with Aortic Valve Regurgitation

“…19) Evora, et al reported the case of an operation on a patient with bovine pericardium cusp replacement, with good ventricular function and minimal structural valve deterioration at a long-term follow-up of 23 years. 20) Regardless of using autologous pericardium or bovine pericardium, pericardium calcification is a main cause for concern and determines the freedom from reoperation over the long-term. At our center, the bovine pericardium we used was the same as bovine pericardial bioprostheses, which have been found to be free of calcification for approximately 10 years.…”

Aortic Valve Repair of a Stenotic Unicuspid Aortic Valve in Young Patients

“…Mosala Nezhad and colleagues [35] did not present any statistical significance to higher freedom from reoperation during 72 AE 42.5 months of follow-up if bovine pericardium was used (95% AE 5%) in comparison with autologous pericardium (73% AE 11%). Other investigators presented a case report of a 23-year long-term follow-up of 1 patient operated with bovine pericardium cusp extension with a good ventricular function and minimal structural valve deterioration [36].…”

Biological and Mechanical Heart Valves Under a New Spotlight: Paradigm Shift and New State of the Art

“…One study reported a long-term follow-up (23 years) of a patient who underwent surgery on the BPV cusp extension. 7 Increasing confidence in the effectiveness of the operation has allowed a faster indication for surgical treatment, as is already the case in mitral valve repair. This change of attitude will allow patients with mild aortic valve regurgitation to be referred for surgery, which can positively alter the natural history of aortic valve insufficiency.…”

“…This change of attitude will allow patients with mild aortic valve regurgitation to be referred for surgery, which can positively alter the natural history of aortic valve insufficiency. 7 In the setting of transcatheter AVR (TAVR) as a minimally invasive alternative to surgical AVR (SAVR), Chakravarty et al, 8 aiming to elucidate the greater propensity of using bioprostheses in relation to anticoagulation, evaluated the impact of anticoagulation after aortic valve replacement. Echocardiograms were performed 30 days and 1 year after TAVR.…”