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J Thorac Cardiovasc Surg 1995;110:511-516
© 1995 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

AORTIC VALVE REPLACEMENT WITH FREEHAND AUTOLOGOUS PERICARDIUM

Riyadh, Saudi Arabia

Supported in part by external grant AT-11-12 from the King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.

Received for publication July 27, 1994. Accepted for publication Jan. 26, 1995. Address for reprints: Carlos M. G. Duran, MD, Chairman, Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh, Saudi Arabia.

Abstract

Fifty-one patients with a mean age of 31.2 years underwent aortic valve replacement with glutaraldehyde-treated autologous pericardium. Pure aortic regurgitation was present in 28 (54.9%), stenosis in 9, and mixed disease in 14. Simultaneous mitral valve repair was done in 17 patients and replacement in 1. There were no hospital and two late deaths. Three patients required reoperation because of failure of the pericardial valve as a result of infective endocarditis in two (5 and 31 months after operation) and commissural tear at 8 months in another. One patient underwent reoperation at 24 months because of failure of the mitral valve repair. The pericardial aortic valve, which had 2+regurgitation since the first operation, was also replaced. Macroscopic and microscopic examination findings in the excised pericardium were excellent. No thromboembolic events have been detected and no patient received anticoagulation therapy except one after mitral valve reoperation and replacement with a mechanical valve. The actuarial survival was 84.53% ± 12.29% at 60 months, freedom from failure of the aortic reconstruction 83.83% ± 8.59%, and freedom from any event 72.59% ± 12.79%. Doppler echocardiographic study at most recent follow-up showed a mean gradient of 12.56 ± 8.10 mm Hg and mean regurgitation on a scale from 0 to 4+of 0.80 ± 0.66. Although the maximum follow-up is only 5 years, the results obtained so far encourage us to continue replacing the aortic valve with stentless autologous pericardium. (J THORACCARDIOVASCSURG1995;110:511-6)

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