AORTIC-VALVE REPLACEMENT WITH FREEHAND AUTOLOGOUS PERICARDIUM

Fifty-one patients with a mean age of 31.2 years underwent aortic valv e replacement with glutaraldehyde-treated autologous pericardium. Pure aortic regurgitation was present in 28 (54.9%), stenosis in 9, and mi xed disease in 14, Simultaneous mitral valve repair was done in 17 pat ients and replacement in 1, There were no hospital and two late deaths , Three patients required reoperation because of failure of the perica rdial valve as a result of infective endocarditis in two (5 and 31 mon ths after operation) and commissural tear at 8 months in another, One patient underwent reoperation at 24 months because of failure of the m itral valve repair, The pericardial aortic valve, which had 2+ regurgi tation since the first operation, was also replaced. Macroscopic and m icroscopic examination findings in the excised pericardium were excell ent. No thromboembolic events have been detected and no patient receiv ed anticoagulation therapy except one after mitral valve reoperation a nd replacement with a mechanical valve, The actuarial survival was 84. 53% +/- 12.29% at 60 months, freedom from failure of the aortic recons truction 83.83% +/- 8.59%, and freedom from any event 72.59% +/- 12.79 %, Doppler echocardiographic study at most recent follow up showed a m ean gradient of 12.56 +/- 8.10 mm Hg and mean regurgitation on a scale from 0 to 4+ of 0.80 +/- 0.66, Although the maximum follow-up is only 5 years, the results obtained so far encourage us to continue replaci ng the aortic valve with stentless autologous pericardium.