title: Aortic valve repair of congenital stenosis with bovine pericardium.
abstract: BACKGROUND
  Conservative surgical options in the treatment of congenital aortic stenosis are limited. To relieve the obstruction necessitates full incision of the raphe of the larger valve leaflet, but this inevitably causes prolapse.
  
  
  METHODS
  We performed aortic valve repair in 6 children, aged 14 months to 17 years, with congenital aortic stenosis, 2 having had aortic valvotomy as infants. The repair consisted of suturing the base of a triangular piece of bovine pericardium, with a simple vertical fold, to the free edges of the incised raphe. The pericardial fold was then sutured vertically to the aortic wall.
  
  
  RESULTS
  At follow-up of 2 to 60 months, the mean peak systolic Doppler gradients had decreased from 80 +/- 15 mm Hg to 26 +/- 9 mm Hg. The effective valvular orifice area increased from 33% +/- 6% to 64% +/- 3%, allowing blood flow to increase by a factor of 3.76. Two patients have mild and 2 have mild-to-moderate aortic regurgitation.
  
  
  CONCLUSIONS
  The described conservative repair renders the valve tricuspid and trisinusoidal, and the deficient interleaflet triangle is recreated, preventing cusp prolapse. Longer follow-up is required to assess the durability of unstented pericardium in the aortic position, but the early results are encouraging.
authors.affiliation: Wessex Cardiothoracic Centre, General Hospital Southampton, England.
authors.forename: M J
authors.initials: MJ
authors.lastname: Tolan
authors.forename: P E
authors.initials: PE
authors.lastname: Daubeney
authors.forename: Z
authors.initials: Z
authors.lastname: Slavik
authors.forename: B R
authors.initials: BR
authors.lastname: Keeton
authors.forename: A P
authors.initials: AP
authors.lastname: Salmon
authors.forename: J L
authors.initials: JL
authors.lastname: Monro
mesh_terms: D000293:Adolescent; D000818:Animals; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D006801:Humans; D007223:Infant; D010496:Pericardium / Q000637:transplantation*; D016896:Treatment Outcome