Single cusp replacement for aortic regurgitation.

Abstract

Aortic insufficiency is a common disease in cardiac surgery. The frequency of native aortic valve repair in the young is increasing, reflecting a lack of consensus on the optimal therapeutic solution from the growing number of mechanical and biological prostheses. Bovine pericardium was used to replace the coronary leaflet to treat aortic insufficiency in 21 patients aged 4 to 39 years (19 +/- 9.2). Aortic insufficiency was severe in 18 patients and moderate to severe in 3 patients. Seventeen patents had ventricular septal defects (VSD). One had associated rupture of the right sinus of Valsalva without VSD and 3 other patients had acquired heart disease (1 had infective endocarditis and 2 had rheumatic heart disease). There was no mortality. The follow-up ranged from 6 to 21 months. Thirteen patients had complete relief of aortic insufficiency, 7 had mild residual aortic insufficiency, and 1 had moderate aortic insufficiency. Replacement of the diseased leaflet with bovine pericardium is a promising technique for young patients. The short-term outcomes are encouraging, but longer follow-up is required to assess the durability and function of bovine pericardial leaflet in the aortic position.