Open Access
Thorac Cardiovasc Surg 2018; 66(S 02): S111-S138
DOI: 10.1055/s-0038-1628330
Oral Presentations
Tuesday, February 20, 2018
DGPK: Aortic Valve Stenosis – Surgical and Interventional Therapy
Georg Thieme Verlag KG Stuttgart · New York

Aortic Valve Repair Using Decellularized Bovine Pericardium Show Poor Results in Congenital Surgery

S. Nordmeyer
1   Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
P. Murin
2   Department of Surgery for Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
J. Nordmeyer
1   Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
K. Schmitt
1   Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
O. Miera
1   Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
M.Y. Cho
2   Department of Surgery for Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
N. Sinzobahamvya
2   Department of Surgery for Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
F. Berger
1   Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
S. Ovroutski
1   Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
,
J. Photiadis
2   Department of Surgery for Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

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Objectives: The search for optimal patch material for aortic valve reconstruction (AVR) is an ongoing challenge. In this study, we report our initial experience of AVR in congenital heart surgery (CHS) using decellularized bovine pericardial patch material.

Methods: Data of 40 consecutive patients who underwent AVR with decellularized bovine pericardial patch between February 2014 and August 2016 were retrospectively reviewed. Median age at operation was 9 (2–34) years, 18 patients were younger than 7 years. 26 patients presented initially with aortic valve insufficiency (AI) and 14 with stenosis (AS). Clinical and echocardiographic data were available until August 2017 for a median postoperative follow-up (FU) of 20 (0.1–39) months.

Results: Nine of 40 patients (23%) suffered from an event during FU (death: n = 1, 2.5%; reoperation: n = 8, 20%). Overall, the probability of freedom from re-operation/death was 100%, 89% ± 6% and 56% ± 12% at median 10, 20 and 30 months FU, respectively. Reason for re-operation was stenosis in 3 patients (8%), insufficiency in 4 patients (10%) and 1 patient (2.5%) was diagnosed with aortic valve endocarditis. Of the remaining 31 patients, 2 patients are scheduled for re-operation (AS: n = 1, AI: n = 1) and 9 patients show worsening of aortic valve function with moderate AI. Freedom from developing combined endpoint (death/re-operation/moderate degree of aortic valve dysfunction (AS, AI)) after AVR was 97% ± 2.5%, 73% ± 8%, and 33% ± 9% at 10, 20, and 30 months, respectively. On multivariate testing including the following parameters: age at operation, cardiopulmonary bypass time, pre-operative aortic annulus z-score, AS or AI as primary diagnoses and type of reconstruction (bicuspid, tricuspid), no association for reoperation/death and worsening of aortic valve function could be found.

Conclusion: AVR using decellularized bovine pericardial patch material in patients with congenital aortic valve disease show poor results already at 30 months FU.