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Tailored Cusp Extension Valvuloplasty for Aortic Valve Reconstruction in Children
Objective: Aortic valve repair has encouraging mid- and long-term results in selected patients. This video describes the tailored cusp extension valvuloplasty surgical technique.
Methods: A 15-year-old girl presented with severe aortic valve regurgitation, moderate stenosis, and a dilated left ventricle. She was referred for cusp extension valvuloplasty. A large segment of anterior pericardium was very carefully prepared (the loose fatty areolar tissue was bluntly dissected away) and harvested. The free edge length and height of each cusp, as well as the diameter of the sinotubular junction and aortic annulus, were measured and used to tailor three pericardial patches.
Results: Postoperative echocardiogram showed trivial aortic regurgitation with no stenosis. The patient was rapidly extubated and had an uncomplicated post-operative course. She was doing well at one year follow-up exam.
Conclusions: Tailored aortic cusp extension provides excellent valve repair in a large proportion of children with rheumatic aortic regurgitation.