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Aortic Valve Replacement with Stentless Autologous Gluteraldehyde Treated Pericardium
By A. Sampath Kumar, MD and Carlos MG Duran, MD, PhD
This video demonstrates a very elegant technique of creating a trileaflet aortic valve utilizing the patient's own pericardium. Although the technique is very impressive, its clinical application is questionable. The neo-aortic valve has no advantage over a stented or stentless bioprosthesis or a homograft, but it will certainly lack the consistency of the bioprostheses. It cannot be used in the pediatric population, since it will not grow along with the patient. It will also need to stand against a very impressive long term durability record established by the current era stented bovine pericardial valves (85% freedom of reoperation in 19 years). I would like to see a series of these patients 10 years out of surgery with good echocardiographic follow up before adding this procedure to my armamentarium.
George Tolis Jr., MD Author's Reply
Thank you for the comments. I do hope you liked the quality of the video presentation. The technique has the unique advantage of being absolutely free. This is a great advantage indeed in developing countries where cost of surgery is a major consideration. In addition Dr. Al Halees, et al, have published a 16-year followup of patients who received this pericardial valve. The results are comparable to the tissue valve results (Al Halees, et al, Eur J Cardiothorac Surg 2005;28:200-05). I believe this technique has great promise in this part of the world.