Aortic Neocuspidization with Autologous Pericardium: Initial Experience of Single Center

Kubilay Karabacak,Murat Celik,Suat Doganci,Murat Kadan,Cengiz Bolcal,Furkan Burak Akyol,Gökhan Erol,Mehmet Emin Ince,Emre Kubat,Elgin Hacızade,Uygar Cagdas Yuksel

doi:10.4236/wjcs.2021.116008

Abstract

Background: Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with the publication of the mid-long term successful results. The aim of this study was to present initial experience of the AVNeo procedure of a single center. Methods: The medical records of 24 patients who underwent AVNeo with or without concomitant cardiac surgery between February 2019 and February 2021 at our tertiary hospital were scanned retrospectively. Results: The mean age of patients was aged 58.21 ± 13.14 years and 16 (66.7%) of them were men. 16 patients were operated on for aortic stenosis (66.67%). Morphology of the aortic valve was tricuspid in 21 (87.5%) and bicuspid in 3 (12.5%) of the patients. Additional cardicac surgery was performed in 13 (54.17%) patients. No patients needed reoperation for bleeding, pacemaker implantations, conversion to classical prosthetic aortic valve replacement, or infective endocarditis. Two patients died due to non-cardiac reasons. Preoperative peak and mean aortic valve pressures improved significantly at 1st and 6th months (Preop: 89.06 ± 21.88 mmHg and 56.38 ± 15.09 mmHg 1st month: 22.00 ± 3.93 mmHg and 8.73 ± 2.60 mmHg, 6th month: 18.13 ± 3.02 mmHg and 6.93 ± 1.83 mmHg). Conclusion: In conclusion, the AVNeo procedure is a feasible technique for aortic valve pathologies, with the advantages of avoiding anticoagulants and the applicability of concomitant surgical procedures. Although this procedure requires meticulous experience, results similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed.

Highlights

Aortic valve replacement (AVR) with mechanical or bioprosthetic valves is still a standart approach for aortic valve diseases
aortic valve neocuspidization (AVNeo) procedure has been adopted by limited centers with the publication of the mid-long term successful results
Preoperative echocardiographic measurements of the patients revealed the mean left ventricular ejection fraction of 59% ± 7.2% and mean aortic annulus diameter of 23.1 ± 2.8 mm. 13 (54.17%) patients needed concomitant cardiac procedures. 16 (66.67%) patients presented with aortic stenosis (AS)

Summary

Introduction

Aortic valve replacement (AVR) with mechanical or bioprosthetic valves is still a standart approach for aortic valve diseases. AVNeo procedure has been adopted by limited centers with the publication of the mid-long term successful results. Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with the publication of the mid-long term successful results. Conclusion: In conclusion, the AVNeo procedure is a feasible technique for aortic valve pathologies, with the advantages of avoiding anticoagulants and the applicability of concomitant surgical procedures. This procedure requires meticulous experience, results similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed

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Results

Conclusion