Up to 16 years follow-up of aortic valve reconstruction with pericardium: a stentless readily available cheap valve?☆

Halees, Zohair Al; Shahid, Maie; Sanei, Aly Al; Sallehuddin, Ahmed; Durán, Carlos M.G.

doi:10.1016/j.ejcts.2005.04.041

Cited by 141 publications

(121 citation statements)

References 15 publications

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“…Although the study was shorter in time (up till 11 months), the authors argue that the autologous pericardium briefly treated with glutaraldehyde is a superior material. Still, endocarditis as a consequence of the material cannot be excluded as Al Halees and colleagues 40 reported an increased incidence in humans with autologous pericardial valves briefly treated with glutaraldehyde. The authors speculate that the short glutaraldehyde treatment reduces the toxicity of the pericardium but not in the measure to prevent endocarditis as effectively as fully tanned pericardium.…”

Section: Discussionmentioning

confidence: 99%

Tissue-Engineered Fibrin-Based Heart Valve with a Tubular Leaflet Design

Weber

Heta

Moreira

et al. 2014

Tissue Engineering Part C: Methods

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The general approach in heart valve tissue engineering is to mimic the shape of the native valve in the attempt to recreate the natural haemodynamics. In this article, we report the fabrication of the first tissue-engineered heart valve (TEHV) based on a tubular leaflet design, where the function of the leaflets of semilunar heart valves is performed by a simple tubular construct sutured along a circumferential line at the root and at three single points at the sinotubular junction. The tubular design is a recent development in pericardial (nonviable) bioprostheses, which has attracted interest because of the simplicity of the construction and the reliability of the implantation technique. Here we push the potential of the concept further from the fabrication and material point of view to realize the tube-in-tube valve: an autologous, living HV with remodelling and growing capability, physiological haemocompatibility, simple to construct and fast to implant. We developed two different fabrication/conditioning procedures and produced fibrin-based constructs embedding cells from the ovine umbilical cord artery according to the two different approaches. Tissue formation was confirmed by histology and immunohistology. The design of the tube-in-tube foresees the possibility of using a textile coscaffold (here demonstrated with a warp-knitted mesh) to achieve enhanced mechanical properties in vision of implantation in the aortic position. The tube-in-tube represents an attractive alternative to the conventional design of TEHVs aiming at reproducing the valvular geometry.

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Section: Discussionmentioning

confidence: 99%

Tissue-Engineered Fibrin-Based Heart Valve with a Tubular Leaflet Design

Weber

Heta

Moreira

et al. 2014

Tissue Engineering Part C: Methods

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show abstract

“…No patient had a mean gradient of 19 mmHg or greater, or a valve area index of 0.75 cm 2 /m 2 or below. In a long-term follow-up study of young adult patients (mean age, 30 yr; age range, 12-68 yr) who underwent AVRS with use of bovine and autologous pericardium, 20 the 2 pericardium groups did not differ in terms of performance at 15 years or in the incidence of calcification and endocarditis. Along with recent improvements in commercial bovine pericardium, the low pressure gradients associated with reconstructed aortic valves might improve long-term durability.…”

Section: Discussionmentioning

confidence: 99%

Aortic Valve Reconstruction with Use of Pericardial Leaflets in Adults with Bicuspid Aortic Valve Disease: Early and Midterm Outcomes

Song¹,

Yang²,

Choi³

et al. 2014

Texas Heart Institute Journal

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In this study, we retrospectively analyzed the outcomes of adults with bicuspid aortic valve (BAV) Bicuspid aortic valve (BAV) is a congenital anomaly with an incidence of 1% to 2.5% and a higher prevalence in men.1,2 In people with BAV, 85% of subsequent valvular disease consists of aortic stenosis that presents after the 5th decade of life.3 Isolated aortic valve regurgitation is less frequent and usually manifests itself earlier in life. 4 Most patients who have BAVs associated with pure regurgitation undergo repair; however, stenotic BAVs are typically replaced with artificial valves. 5Although regurgitant BAVs are usually repaired, repaired BAVs have significant valve gradients, and early reoperation for valve replacement is necessary. 6 In addition, because most stenotic BAVs are replaced, the patients cannot avoid the sequelae associated with mechanical valves or the problems associated with bioprosthetic valves. 7As a result, neither valve replacement nor valve repair is a completely satisfactory therapeutic method for BAV disease.We treated BAV disease by performing aortic valve reconstructive surgery (AVRS) that consisted of aortic valve leaflet reconstruction with the use of pericardial patches plus fixation of the sinotubular junction (STJ), and we evaluated the early and midterm outcomes. Patients and MethodsWe retrospectively analyzed the cases of 135 patients (99 men and 36 women; mean age, 49.2 ± 13.1 yr) who underwent AVRS for the treatment of BAV disease at

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“…How ever, the longterm durability of autologous pericardial patches in aortic valvuloplasty is unknown. 11,12 Heter ologous pericardium has also been applied in aortic valve repair. After 11 to 14 months, no or only trace aortic regurgitation was detected in patients whose right coronary aortic valve leaflet was replaced with bovine pericardium.…”

Section: Discussionmentioning

confidence: 99%

Is Autologous or Heterologous Pericardium Better for Valvuloplasty? A Comparative Study of Calcification Propensity

Jiang¹,

Cui²,

Li³

et al. 2015

Texas Heart Institute Journal

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Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium. We randomly divided 28 rabbits into 4 equal groups. Resected rabbit pericardium served as autologous pericardium, and commercial bovine pericardium served as heterologous pericardium. We subcutaneously embedded one of each pericardial patch in the abdominal walls of 21 of the rabbits. The 7 control rabbits (group A) received no implants. The embedded samples were removed at 2 months in group B, at 4 months in group C, and at 6 months in group D. Each collected sample was divided into 2 parts, one for calcium-content measurement by means of atomic-absorption spectroscopy, and one for morphologic and histopathologic examinations. When compared with the autologous pericardium, calcium levels in the heterologous pericardium were higher in groups B, C, and D (P <0.0001, P <0.0002, and P <0.0006, respectively). As embedding time increased, calcium levels in the heterologous pericardium increased faster than those in the autologous, especially in group D. Disorganized arrangements of collagenous fibers, marked calculus, and ossification were seen in the heterologous pericardium. Inflammatory cells—mainly lymphocytes and small numbers of macrophages—infiltrated the heterologous pericardium. The autologous pericardium showed a stronger ability to resist calcification. Our results indicate that autologous pericardium might be a relatively better choice for valvuloplasty.

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Up to 16 years follow-up of aortic valve reconstruction with pericardium: a stentless readily available cheap valve?☆

Cited by 141 publications

References 15 publications

Tissue-Engineered Fibrin-Based Heart Valve with a Tubular Leaflet Design

Tissue-Engineered Fibrin-Based Heart Valve with a Tubular Leaflet Design

Aortic Valve Reconstruction with Use of Pericardial Leaflets in Adults with Bicuspid Aortic Valve Disease: Early and Midterm Outcomes

Is Autologous or Heterologous Pericardium Better for Valvuloplasty? A Comparative Study of Calcification Propensity

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