title: Aortic valve reconstruction of unicuspid aortic valve by tricuspidization using autologous pericardium.
abstract: BACKGROUND
  Unicuspid aortic valve is a rare anatomic variant, but patients may require intervention for severe valve dysfunction at a young age. We introduce a new reconstructive technique for diseased unicuspid valve by tricuspidization with glutaraldehyde-treated autologous pericardium.
  
  
  METHODS
  From April 2007 through January 2011, we performed 304 cases of aortic valve reconstruction using glutaraldehyde-treated autologous pericardium. During the same period, we encountered 9 patients with unicuspid aortic valve, including 8 male patients and 1 female patient. Mean age was 48.9±19.9 years (14-78 years). Two patients had aortic stenosis (AS), 1 had aortic regurgitation (AR), and 6 patients had both. Our original aortic valve reconstruction technique is characterized by the independent replacement of 3 leaflets with separate measurement of length between each commissure. In the case of a unicuspid aortic valve, we create a new commissure at a higher point along the raphe at the same level with the 1 normally existing commissure.
  
  
  RESULTS
  No early mortality or major morbidity was recorded. Postoperative echocardiography showed trivial or no AR, with the peak pressure gradients averaging 10.6±3.3 mm Hg. One-year follow-up echocardiography revealed that the peak pressure gradients averaged 8.6±3.7 mm Hg, with trivial or no AR. The mean follow-up period was 551.1±51.4 days. All 9 patients are in good condition. No reoperation or any additional intervention has been necessary.
  
  
  CONCLUSIONS
  Diseased unicuspid aortic valves were treated by our original aortic valve reconstruction technique with excellent early results. We continue to study the long-term results.
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Isamu
authors: I
authors: Kawase
authors: Shigeyuki
authors: S
authors: Ozaki
authors: Hiromasa
authors: H
authors: Yamashita
authors: Shin
authors: S
authors: Uchida
authors: Yukinari
authors: Y
authors: Nozawa
authors: Takayoshi
authors: T
authors: Matsuyama
authors: Mikio
authors: M
authors: Takatoh
authors: So
authors: S
authors: Hagiwara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult