BACKGROUND: Aortic insufficiency is a common 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.
BACKGROUND:Aortic insufficiency is a common 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.