Abstract 1800: Aortic Valve Sparing Repair with Autologous Pericardial Leaflet Extension Has Low Intermediate-Term Mortality and Re-Operation Rate in Children and Adults
Objectives: We sought to establish whether there was a difference in outcome after aortic valve repair with autologous pericardial leaflet extension in pediatric or adult population.
Methods: One hundred and twenty-eight (n=128) patients (pediatric and adult) underwent valvular pericardial extension repair at our institution from 1997 through 2005. The pediatric group (≤ 18 yrs) (54/128) (42%) with mean age 8.4±5.4 (range, 0–17 yrs). The adult group (74/128) (58%) with mean age 48.9±19.7 (range, 19 – 85 yrs). The endpoints of the study were mortality and re-operation rates.
Results: Thirty-day and late mortality in group A (pediatric) and group B (adult) was 0 (0%) and 1/74(1.3%) and 3/54(5.5%) and 2/73(2.7%), respectively (p=0.1). There were 13 total re-operations: 7/54(12.9%) in group A and 6/74(8.1%) in group B (p=0.1). Eleven total patients required re-operation; 6/54(11.1%) in A and 5/74(6.5%) in B. One in each group was re-operated twice. Re-operations were re-repairs in 3 of group B and 3 of group A, and replacements in 3 of group B and 4 in group A. The mean interval between original repair and re-operation was 4.3±2.5 yrs in A and 2.8±2.2 yrs in B. The remaining patients are well at mean follow-up of 33.1±28 months. In Group A, the mean aortic regurgitation and stenosis grade by echocardiography was 0.8±0.7 and 0.6±0.4, respectively (scale, 0 – 4). In group B, Follow-up mean aortic regurgitation and stenosis were graded 0.8±0.7 and 0.3±0.1, respectively.
Conclusions: There is neither important difference in mortality nor reoperation rate between the two groups. This valve sparing technique is safe, reproducible and repeatable if necessary in both children and adults. Long-term durability is unknown