Short and Midterm Results of Aortic Valve Cusp Extension in the Treatment of Children With Congenital Aortic Valve Disease

Alsoufi, Bahaaldin; Karamlou, Tara; Bradley, Timothy J.; Williams, William G.; Arsdell, Glen S. Van; Coles, John G.; Smallhorn, Jeffrey F.; Nii, Masaki; Guerra, Vitor; Caldarone, Christopher A.

doi:10.1016/j.athoracsur.2006.04.039

Cited by 51 publications

(38 citation statements)

References 19 publications

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“…While the incidence of rheumatic valve disease has significantly decreased in the Western world, it remains a major cause of aortic valvulopathy in developing countries [2]. Several developments in interventional cardiology allowed early treatment of congenital aortic stenosis, while recent experience with aortic valve-repair techniques shows encouraging short-and mid-term results in both congenital and rheumatic valve disease [3,4]. Nonetheless, in patients with significant valve destruction and following repair or intervention failure, aortic valve replacement is required.…”

Section: Introductionmentioning

confidence: 99%

The Ross procedure in children: preoperative haemodynamic manifestation has significant effect on late autograft re-operation☆

Alsoufi

Manlhiot

Fadel

et al. 2010

European Journal of Cardio-Thoracic Surgery

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The Ross procedure in children is associated with excellent survival. Late autograft re-operation may be required; however, it is more common in children with preoperative aortic regurgitation, especially those with rheumatic fever. Better patient selection in later era has mitigated the risk of autograft re-operation. Continued improved candidate selection, along with modifications in autograft implantation and root/sinotubular stabilisation techniques, may further decrease late autograft failure.

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Section: Introductionmentioning

confidence: 99%

The Ross procedure in children: preoperative haemodynamic manifestation has significant effect on late autograft re-operation☆

Alsoufi

Manlhiot

Fadel

et al. 2010

European Journal of Cardio-Thoracic Surgery

Self Cite

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“…In cases of recurrent valvar stenosis and regurgitation, extended aortic valvuloplasty has been described [81,82]. Aortic valve repair by multiple techniques, including pericardial leaflet extension, has been reported recently by multiple authors [83][84][85][86].…”

Section: Surgical Valvotomy and Valvuloplastymentioning

confidence: 99%

“…Furthermore, recent results with pediatric aortic valve repair have been promising [115]. Alsoufi and associates reported their short-term and midterm results of aortic valve repair by cusp extension with autologous pericardium in 22 children who were 5-18 years of age [83]. Among these patients, 16 had previous surgical or related complication rates, when compared with bioprosthetic and mechanical valves [119].…”

Section: Aortic Valve Replacementmentioning

confidence: 99%

Left Ventricular Outflow Tract Obstruction

Tchervenkov

Bernier

Del

et al. 2012

Pediatric Cardiac Surgery

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“…On the other hand, untreated fresh autologous pericardium might possess true growth, but distensibility as well. Despite good short-and mid-term results, it is associated with a high degeneration rate in the long term (11)(12)(13)(14) and is associated with bacterial endocarditis (8,10,15). Bovine pericardium-used as leaflet extension-has been shown to be less effective as compared to autologous pericardium (16,17), and autologous pericardium has greater resistance to retraction.…”

Section: Currently Used Patch Materials For Valve Repairmentioning

confidence: 99%

Surgical technique: establishing a pre-clinical large animal model to test aortic valve leaflet substitute

et al. 2016

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To overcome current limitations of valve substitutes and tissue substitutes the technology of tissue engineering (TE) continues to offer new perspectives in congenital cardiac surgery. We report our experiences and results implanting a decellularized TE patch in nine sheep in orthotropic position as aortic valve leaflet substitute. Establishing the animal model, feasibility, cardiopulmonary bypass issues and operative technique are highlighted. side effect of lifelong anticoagulation. The lack of an ideal valve substitute has raised interest in alternative techniques, such as repairing the diseased valve rather than replacing it. In the past several years, the percentage of valve repair as compared to AVR has increased (1). For many of the aortic valve repair techniques, a patch is needed as substitute, partial or complete replacement or leaflet extension. So far various cusp tissue substitutes have been tested, but failed to fulfill the requirements for an optimal patch material. Currently used patch material for valve repairAn optimal patch material should be pliable, hemostatic and resistant to tearing, should not shrink or calcify, and should possibly not induce an inflammatory cascade. Since the late 1960s, attempts have been made to use biologic materials like fascia lata, dura mater and bovine pericardium with poor outcomes (4-6). An easily available source for valve repair is the autologous pericardium, which is widely used for partial or total cusp replacement or leaflet extension (7-10). Some groups propagate pretreatment with glutaraldehyde, which prevents secondary shrinking and calcification (9,10). On the other hand, untreated fresh autologous pericardium might possess true growth, but distensibility as well. Despite good short-and mid-term results, it is associated with a high degeneration rate in the long term (11)(12)(13)(14) and is associated with bacterial endocarditis (8,10,15). Bovine pericardium-used as leaflet extension-has been shown to be less effective as compared to autologous pericardium (16,17), and autologous pericardium has greater resistance to retraction. Since polytetrafluoroethylene (PTFE) was successfully used for right ventricular outflow graft reconstruction or in mitral leaflet position with good longterm results (18)(19)(20), it was applied as leaflet extension in the aortic valve position. Nosál' and coworkers reported 13 congenitally affected patients, with the youngest being 22 months old, in whom PTFE leaflet extensions were done with a follow-up till 30 months (21). However, there still remains a higher risk of endocarditis, and concerns have been raised about leaflet thickening and decreased mobility (18,22). Technical and scientific achievements in the field of tissue engineering (TE) may offer new perspectives with the potential of an off-the-shelf starter matrix for guided tissue regeneration. Study rationaleThe ultimate goal is to develop an aortic valve leaflet substitute which is physiological, durable and has the potential for growth, and test it in ...

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Short and Midterm Results of Aortic Valve Cusp Extension in the Treatment of Children With Congenital Aortic Valve Disease

Cited by 51 publications

References 19 publications

The Ross procedure in children: preoperative haemodynamic manifestation has significant effect on late autograft re-operation☆

The Ross procedure in children: preoperative haemodynamic manifestation has significant effect on late autograft re-operation☆

Left Ventricular Outflow Tract Obstruction

Surgical technique: establishing a pre-clinical large animal model to test aortic valve leaflet substitute

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