UTILISATION DU PERICARDE AUTOLOGUE TRAITE PAR UN POLYMERE D’HYDROGEL DANS LA RECONSTRUCTION VALVULAIRE AORTIQUE : ETUDE DE FAISABILITE CHEz LE MOUTON

Abstract

The choice of valvular substitute poses numerous challenges particular in the children. The use of the patient own pericardium for constructing heart valve prosthesis is an interesting alternative and has several potential advantages: there is no immune reaction between the host and the implanted valve and their low cost is an attractive solution for patients in the developing countries. The aim of our study is to focus and evaluate technical aspects of construction and implantation of autologous pericardium prosthesis prétraited with polysaccharide gel. Five (5) sheep underwent aortic valve replacement with autologous pericardium prosthesis according to Goetz’s technique using cardiopulmonary bypass. The heart was exposed with a standard left thoracotomy through the 4th intercostal space. Cardiopulmonary bypass and cross-clamp mean time was 145 min and 79 min respectively. The prosthesis mean time construction and surgical implantation was 14 and 49 min respectively. Echocardiograhic study showed trivial central regurgitation in 2 cases. Two sheep died owing myocardial failure at the end of the procedure. Truly stenless aortic valve replacement using autologous pericardium pretraited with a polysaccharide hydrogel is feasible, with cross clamping time acceptable and without precoce structural dégénération. Histological results are particulary useful to evaluate this new method for pericardial valvular implant using polysaccharid gel. Keywords: Aortic valve, autologous pericardium, hydrogel, experimental study, in vivo.