Pericardial patch augmentation for reconstruction of incompetent bicuspid aortic valves.
OBJECTIVE
Reoperation rates after repair of bicuspid aortic valves are higher than for mitral valve reconstruction. Secondary changes and small coaptation surface render repair unreliable. Satisfactory results have been reported for patch augmentation for tricuspid aortic valves. We have applied this technique for the repair of bicuspid aortic valves.


METHODS
Our technique retains the bicuspid morphology of the incompetent aortic valve. A strip of glutaraldehyde-fixed pericardium is sutured to the free edge of the fused leaflet. A large coaptation surface is created, and competence of the bicuspid valve is achieved.


RESULTS
Sixteen patients underwent reconstruction of their bicuspid aortic valves by pericardial patch augmentation. There were no intraoperative or postoperative deaths. The degree of aortic regurgitation was none to trivial for all patients at a mean follow-up of 3.1 +/- 3.4 months. Planimetric effective orifice areas ranged above 2 cm2. Mean aortic gradients were 8.2 +/- 4.8 mm Hg, and the mean height of coaptation surface was 14.7 +/- 2.1 mm.


CONCLUSIONS
The pericardial patch augmentation technique increases coaptation surface, and thus provides reliable early competence of reconstructed bicuspid aortic valves.
Doss
Mirko
M
Department of Thoracic and Cardiovascular Surgery, J. W. Goethe University, Frankfurt am Main, Germany. mirkodoss@aol.com
Moid
Reinhard
R
Wood
Jeffrey Paul
JP
Miskovic
Aleksandra
A
Martens
Sven
S
Moritz
Anton
A
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*