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Original Articles: Cardiovascular

Single Cusp Replacement for Aortic Regurgitation

^a Cardiac Surgical Department, Wuhan Asia Heart Hospital, WuHan, China
^b Cardiothoracic Surgical Department, Singapore National Heart Center, Singapore

Accepted for publication October 9, 2007.

^_* Address correspondence to Dr Zeng, WuHan Asia Heart Hospital, WuHan, 430022, China (Email: xiangjunzeng{at}163.com).

Background: Aortic insufficiency is a commmon disease in cardiac surgery. The frequency of native aortic valve repair in the young is increasing, reflecting a lack of consensus on the optimal therapeutic solution from the growing number of mechanical and biological prostheses.

Methods: Bovine pericardium was used to replace the coronary leaflet to treat aortic insufficiency in 21 patients aged 4 to 39 years (19 ± 9.2). Aortic insufficiency was severe in 18 patients and moderate to severe in 3 patients. Seventeen patents had ventricular septal defects (VSD). One had associated rupture of the right sinus of Valsalva without VSD and 3 other patients had acquired heart disease (1 had infective endocarditis and 2 had rheumatic heart disease).

Results: There was no mortality. The follow-up ranged from 6 to 21 months. Thirteen patients had complete relief of aortic insufficiency, 7 had mild residual aortic insufficiency, and 1 had moderate aortic insufficiency.

Conclusions: Replacement of the diseased leaflet with bovine pericardium is a promising technique for young patients. The short-term outcomes are encouraging, but longer follow-up is required to assess the durability and function of bovine pericardial leaflet in the aortic position.