Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspective
Objectives: Aortic valve repair can be limited by inadequate leaflet tissue for proper coaptation. Various kinds of pericardium have been used for cusp augmentation, but most have failed because of tissue degeneration. A more durable leaflet substitute is needed. Methods: In this report, 8 consecuti...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250723001116 |
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| author | John L. Myers, MD J. Brian Clark, MD Timothy W. James, MD Emily Downs, MD Saad M. Hasan, MD Robert S. Binford, MD Jeffrey D. McNeil, MD Victor M. Rodriquez, MD Christopher E. Mascio, MD Lawrence M. Wei, MD Vinay Badhwar, MD J. Scott Rankin, MD |
| author_facet | John L. Myers, MD J. Brian Clark, MD Timothy W. James, MD Emily Downs, MD Saad M. Hasan, MD Robert S. Binford, MD Jeffrey D. McNeil, MD Victor M. Rodriquez, MD Christopher E. Mascio, MD Lawrence M. Wei, MD Vinay Badhwar, MD J. Scott Rankin, MD |
| author_sort | John L. Myers, MD |
| collection | DOAJ |
| description | Objectives: Aortic valve repair can be limited by inadequate leaflet tissue for proper coaptation. Various kinds of pericardium have been used for cusp augmentation, but most have failed because of tissue degeneration. A more durable leaflet substitute is needed. Methods: In this report, 8 consecutive cases are presented in which autologous ascending aortic tissue was used to augment inadequate native cusps during aortic valve repair. Biologically, aortic wall is a living autologous tissue that could have exceptional durability as a leaflet substitute. Techniques for insertion are described in detail, along with procedural videos. Results: Early surgical outcomes were excellent, with no operative mortalities or complications, and all valves were competent with low valve gradients. Patient follow-up and echocardiograms to a maximum of 8 months’ postrepair remain excellent. Conclusions: Because of superior biologic characteristics, aortic wall has the potential to provide a better leaflet substitute during aortic valve repair and to expand patient categories amenable to autologous reconstruction. More experience and follow-up should be generated. |
| format | Article |
| id | doaj-art-52142020234a4c11a2ae3045f5a9e50e |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-52142020234a4c11a2ae3045f5a9e50e2025-08-20T03:38:26ZengElsevierJTCVS Techniques2666-25072023-06-0119303710.1016/j.xjtc.2023.02.017Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspectiveJohn L. Myers, MD0J. Brian Clark, MD1Timothy W. James, MD2Emily Downs, MD3Saad M. Hasan, MD4Robert S. Binford, MD5Jeffrey D. McNeil, MD6Victor M. Rodriquez, MD7Christopher E. Mascio, MD8Lawrence M. Wei, MD9Vinay Badhwar, MD10J. Scott Rankin, MD11Pennsylvania State University, Hershey, PaPennsylvania State University, Hershey, PaSt Joseph's Hospital, Tacoma, WashUniversity of Virginia, Charlottesville, VaChrist Hospital, Cincinnati, OhioOverlake Hospital, Bellevue, WashCardiothoracic and Vascular Surgeons of Austin, Austin, TexSutter Medical Center, Sacramento, CalifWest Virginia University, Morgantown, WVaWest Virginia University, Morgantown, WVaWest Virginia University, Morgantown, WVaWest Virginia University, Morgantown, WVa; Address for reprints: J. Scott Rankin, MD, WVU Heart and Vascular Institute, 1 Medical Center Dr, Morgantown, WV 26506.Objectives: Aortic valve repair can be limited by inadequate leaflet tissue for proper coaptation. Various kinds of pericardium have been used for cusp augmentation, but most have failed because of tissue degeneration. A more durable leaflet substitute is needed. Methods: In this report, 8 consecutive cases are presented in which autologous ascending aortic tissue was used to augment inadequate native cusps during aortic valve repair. Biologically, aortic wall is a living autologous tissue that could have exceptional durability as a leaflet substitute. Techniques for insertion are described in detail, along with procedural videos. Results: Early surgical outcomes were excellent, with no operative mortalities or complications, and all valves were competent with low valve gradients. Patient follow-up and echocardiograms to a maximum of 8 months’ postrepair remain excellent. Conclusions: Because of superior biologic characteristics, aortic wall has the potential to provide a better leaflet substitute during aortic valve repair and to expand patient categories amenable to autologous reconstruction. More experience and follow-up should be generated.http://www.sciencedirect.com/science/article/pii/S2666250723001116aortic valve repairaortic leaflet replacementleaflet defects |
| spellingShingle | John L. Myers, MD J. Brian Clark, MD Timothy W. James, MD Emily Downs, MD Saad M. Hasan, MD Robert S. Binford, MD Jeffrey D. McNeil, MD Victor M. Rodriquez, MD Christopher E. Mascio, MD Lawrence M. Wei, MD Vinay Badhwar, MD J. Scott Rankin, MD Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspective JTCVS Techniques aortic valve repair aortic leaflet replacement leaflet defects |
| title | Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspective |
| title_full | Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspective |
| title_fullStr | Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspective |
| title_full_unstemmed | Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspective |
| title_short | Use of aortic wall patches as leaflet replacement material during aortic valve repairCentral MessagePerspective |
| title_sort | use of aortic wall patches as leaflet replacement material during aortic valve repaircentral messageperspective |
| topic | aortic valve repair aortic leaflet replacement leaflet defects |
| url | http://www.sciencedirect.com/science/article/pii/S2666250723001116 |
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