The utility of aortic valve leaflet reconstruction techniques in children and young adults

Wiggins, Luke M.; Mimic, Branko; Issitt, Richard; Ilić, Slobodan; Bonello, Béatrice; Marek, Jan; Kostolny, Martin

doi:10.1016/j.jtcvs.2019.09.176

Cited by 73 publications

(81 citation statements)

References 34 publications

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“…A recent report of 58 children who underwent the Ozaki technique for aortic valve surgery between 2015 and 2019 demonstrated stable gradients at a median follow-up of 14 months and freedom from moderate or greater aortic regurgitation of 80% at 3 years. 7 Similarly, another recent study reported the outcomes of 57 children who underwent the Ozaki procedure between 2015 and 2019 and demonstrated stable gradients and degree of aortic valve regurgitation at a median follow-up of 17 months. 8 Although the Ozaki procedure could be useful in selected patients, its role in children will be determined by the long-term outcomes.…”

Section: Aortic Valve Surgerymentioning

confidence: 92%

Highlights in congenital cardiothoracic surgery: 2020–2021

Buratto¹,

Konstantinov²

2021

The Journal of Thoracic and Cardiovascular Surgery

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Advances in congenital cardiothoracic surgery continue at a rapid pace. This year, for the first time, the Editorial Board of the Journal provides focused summaries of the key articles published in the American Association for Thoracic Surgery (AATS) journals during the year preceding the annual AATS meeting. These series of focused summaries will be published at the time of the AATS meetings. This particular compendium features articles on 3 topics: aortic valve surgery, the arterial switch operation (ASO), and atrioventricular septal defect (AVSD) repair.

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Section: Aortic Valve Surgerymentioning

confidence: 92%

Highlights in congenital cardiothoracic surgery: 2020–2021

Buratto¹,

Konstantinov²

2021

The Journal of Thoracic and Cardiovascular Surgery

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“…[3][4] When choosing a material for use during repair, durability and functionality must be considered in order to successfully preserve the left ventricle function and minimize the number of reoperations needed over a lifetime. 5 Currently, the search for the optimal leaflet replacement material requires further exploration. Aortic valve repair is traditionally accomplished using autologous pericardium, which provides acceptable durability when treated with glutaraldehyde yet suffers from problems with calcification and eventual degradation.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Aortic Valve Repair: Any development in the material for cusp extension valvuloplasty?

Siddiqi

Lee³

et al. 2021

Preprint

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Background: Aortic cusp extension is a technique for aortic valve (AV) repairs in pediatric patients. The choice of the material used in this procedure may influence the time before reoperation is required. We aimed to assess post-operative and long-term outcomes of patients receiving either pericardial or synthetic repairs. Methods: We conducted a single center, retrospective study of pediatric patients undergoing aortic cusp extension valvuloplasty (N=38) with either autologous pericardium (n=30) or Cormatrix (n=8) between April 2009 and July 2016. Short and long-term postoperative outcomes were compared between the two groups. Freedom from reoperation was compared using Kaplan Meier analysis. Degree of aortic stenosis (AS) and aortic regurgitation (AR) were recorded at baseline, post-operatively, and at outpatient follow-up. Results: At five years after repair, freedom from reoperation was significantly lower in the CorMatrix group (12.5%) compared to the pericardium group (62.5%) (P = 0.01). For the entire cohort, there was a statistically significant decrease in the peak trans-valvar gradient between pre- and post-operative assessments with no significant change at outpatient follow-up. In the pericardium group, 28 (93%) had moderate to severe AR at baseline which improved to 11 (37%) post-operatively and increased to 21 (70%) at time of follow-up. In the biomaterial group, 8 (100%) had moderate to severe AR which improved to 3 (38%) post-operatively and increased to 7 (88%) at time of follow-up. Conclusion: In terms of durability, the traditional autologous pericardium may outperform the new CorMatrix for AV repairs using the cusp extension method.

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“…In this issue of the Journal, Wiggins and colleagues 5 provide an extensive outcome analysis of complex aortic valve reconstruction with tricuspidalization by neotricuspidalization (Ozaki procedure, n ¼ 40) or single leaflet reconstruction (n ¼ 18) in 58 children and young adolescents. 5 In 22 patients, balloon valvuloplasty was performed before the surgical procedure. The authors made individual decisions for the surgical procedure of choice on each patient using preoperative and perioperative 3-dimensional echocardiographic imaging and finally their intraoperative assessment.…”

mentioning

confidence: 99%