title: Aortic valve reconstruction using autologous pericardium for patients aged less than 60 years.
abstract: OBJECTIVE
  We have performed an original aortic valve reconstruction using autologous pericardium. The feasibility for patients aged less than 60 years is reviewed.
  
  
  METHODS
  From April 2007 to April 2013, aortic valve reconstruction was performed in 108 patients aged less than 60 years. A total of 51 patients had aortic stenosis, 7 patients had annuloaortic ectasia, 7 patients had infective endocarditis, and 43 patients had aortic regurgitation. Fifty-seven patients had bicuspid valves, and 11 patients had unicuspid valves. There were 75 male and 33 female patients, with a mean age of 47.8 ± 11.2 years. Preoperative echocardiography showed an average peak pressure gradient of 86.1 ± 35.1 mm Hg with aortic stenosis. The surgical procedure is based on the independent tricuspid replacement using autologous pericardium. First, the distance between the commissures is measured using an original sizing apparatus, and then the pericardial cusp is trimmed using an original template and sutured to the annulus.
  
  
  RESULTS
  There was no conversion to prosthetic valve replacement. There were no in-hospital mortalities. Postoperative echocardiography showed an average peak pressure gradient of 14.8 ± 7.8 mm Hg 1 week after surgery and 12.8 ± 3.1 mm Hg 4 years after surgery. One patient required reoperation because of infective endocarditis. The other 107 patients showed less than mild aortic regurgitation. No thromboembolic events were recorded. The mean follow-up period was 34.2 ± 15.7 months. Freedom from reoperation was 98.9% with 76 months of follow-up.
  
  
  CONCLUSIONS
  Original aortic valve reconstruction was feasible for patients aged less than 60 years. Long-term data will be disclosed in the future.
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan. Electronic address: ozakis@oha.toho-u.ac.jp.
authors: Shigeyuki
authors: S
authors: Ozaki
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Isamu
authors: I
authors: Kawase
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Hiromasa
authors: H
authors: Yamashita
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Yukinari
authors: Y
authors: Nozawa
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Mikio
authors: M
authors: Takatoh
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: So
authors: S
authors: Hagiwara
authors: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors: Nagaki
authors: N
authors: Kiyohara
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001021:Aortic Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult