Pathological Changes in the Autologous Pericardial Aortic Valve at 10 Years
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 4
Abstract
A 41-year old patient who underwent a successful re-operation 10 years following aortic valve replacement with autologous pericardium is reported. The findings at re-operation are discussed.Aortic valve replacement with a stentless autologous pericardial valve was proposed by Duran and colleagues to avoid complications of a Mechanical Valve (mAVR). The procedure has been demonstrated to be an inexpensive substitute to mAVR and avoids long term costs and compliance associated with anticoagulation, more so in the third world [1,2]. Acceptable midterm and long term results have been reported [2-5]. However, it is not expected to be a permanent substitute because the pericardium is expected to undergo degenerative changes in the mid to long term. Therefore, it is essential for the surgeons to be aware of what to expect at re-operation and be prepared to perform a safe re-operation. We recently successfully re-operated one such patient who had undergone pericardial AVR and report the findings as well as the technique of re-operationOur institutional ethics committee waived the need for a formal ethics committee approval and the patient gave consent to publish this report and images. A 41 year old male patient presented with dyspnea on exertion NYHA class II of six months duration. Ten years ago, he was operated upon by the Senior Author (ASK). At that time, the native aortic valve leaflets were excised and the aortic valve annulus was sized using special Duran’s valve seizers. A strip of pericardium was cut using specially designed moulds and the pericardial strip was buttressed between two snugly fitting parts of that mould. This was immersed in 0.625% glutaraldehyde for 10 minutes and was later rinsed in normal saline. The resultant trileaflet pericardial valve was sutured inside the aorta using the technique .
Authors and Affiliations
Sachin Talwar, Neeti Makhija, Ira Dhawan, Arkalgud Sampath Kumar
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