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Ann Thorac Surg 2005;80:304-307
© 2005 The Society of Thoracic Surgeons

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New technology

Pericardial Patch Augmentation for Reconstruction of Incompetent Bicuspid Aortic Valves

^a Department of Thoracic and Cardiovascular Surgery, J. W. Goethe University, Frankfurt am Main, Germany
^b Department of Surgery, University of Vienna, Vienna, Austria

Accepted for publication August 19, 2004.

^_* Address reprint requests to Dr Doss, Department of Thoracic and Cardiovascular Surgery, J. W. Goethe University, Frankfurt am Main, Theodor Stern Kai 7, 60599 Frankfurt am Main, Germany (Email: mirkodoss{at}aol.com).

PURPOSE: 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.

DESCRIPTION: 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.

EVALUATION: 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.

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Invited commentary

Carlos M.G. Duran
Ann. Thorac. Surg. 2005 80: 307-308. [Extract] [Full Text] [PDF]

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