Aortic valve replacement with single strip autologous pericardium.

Abstract

Aortic valve replacement with mechanical valves is the standard treatment for aortic valve disease in Indonesia. Its usage is associated with high cost, risk of endocarditis and thromboembolic event, and lifetime consumption of anticoagulants. We perform a novel replacement technique of the aortic valve using an autologous pericardium and evaluate short-term outcomes. From April 2017 to April 2020, 16 patients underwent aortic valve replacement with a single-strip autologous pericardium. Outcomes of left ventricle reverse remodeling (LVRR), six minutes walking test (6MWT), and soluble suppression of tumorigenicity-2 (sST-2) were measured at 6 months post-operation. A total of 16 surgeries were performed using aortic valve replacement with single strip pericardium without conversion to mechanical valve replacement. The patients included 8 males and 8 females, and the mean age was 49.63 + 12.54 years old. The most common diagnosis was mixed aortic valve stenosis and regurgitation (9 cases). The mean aortic cross-clamp time was 139.88 + 23.21 min and cardiopulmonary bypass time was 174.37 + 33.53 min. At 6 months post operation, there were an increase of 6MWT (p = 0,006) and a decrease of sST-2 level (p = 0,098). Echocardiographic showed 2 patients had LVRR. Survival and freedom from reoperation are 100% at one-year follow-up. Aortic valve replacement with single strip pericardium is a good alternative to aortic valve replacement with a mechanical valve. Short-term evaluation at 6 months post-operation showed improvement in clinical status and echocardiographic parameters compared to baseline.