A simple method of aortic valve reconstruction with fixed pericardium in children

Abstract

Aortic valve reconstruction with fixed pericardium may occasionally be very useful when treating children with aortic valve disease. This is because diseased aortic valves in children are sometimes too dysmorphic for simple repair without the addition of material, their annulus may be too small for a prosthesis, and the Ross operation may be precluded due to other congenital anomalies such as pulmonary valvar or coronary malformations. Such reconstruction is usually technically demanding and requires much precision. We describe a simple alternative method, which we have carried out in 3 patients, aged 1 week, 3 years and 12 years, respectively, with good early results.

Figures

Figure 1:

Note that the patch is sutured in a horizontal plane: the suture line does not follow the hinge-point of the leaflets of the native aortic valve up to the tip of the commissures.

Figure 2:

Intraoperative picture showing the final result, with the commissural stitches tied outside the aorta.

Supplementary Video 1:

Transthoracic echocardiogram showing a well-functioning neo-aortic valve.