Pericardial Patch Augmentation Is Associated With a Higher Risk of Recurrent Aortic Insufficiency

Eilon Ram, Yaron Moshkovitz, Ami Shinfeld, Alexander Kogan, Alexander Lipey, Sagit Ben Zekry, Ronny Ben-Avi, Shany Levin, Ehud Raanani*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: This study assessed early and late clinical outcomes in patients who underwent aortic valve repair or an aortic valve-sparing operation and investigated predictors for failure. Methods: Of 227 consecutive patients who underwent aortic valve repair or a valve-sparing operation in our department between 2004 and 2016, 81 (36%) underwent aortic root replacement with or without cusp repair, 97 (42%) ascending aorta replacement with or without cusp repair, and 49 (22%) isolated aortic valve repair. Clinical and echocardiographic follow-up was complete. Results: One patient (0.4%) died in-hospital. Mean clinical and echocardiographic follow-up was 69 ± 40 months (range, 1 to 147 months) and 53 ± 40 months (range, 1 to 147 months), respectively. Fifteen patients (6.6%) died during follow-up, with an overall 5-year survival rate of 94.4%. Recurrent significant (≥3) aortic insufficiency developed in 20 patients (8.8%), 17 of whom underwent reoperation, with a 5-year freedom from reoperation rate of 88%. Predictors for recurrent significant aortic insufficiency or reoperation were greater preoperative aortic insufficiency (grade III to IV vs I to II; relative risk [RR], 1.97; p = 0.023), cusp repair (RR, 2.92; p = 0.001), higher European System for Cardiac Operative Risk Evaluation score (RR, 1.16; p = 0.006), and valve repair with pericardial patch augmentation (RR, 2.34; p = 0.032). Conclusions: Aortic valve repair and valve-sparing operations can be performed with good early and late clinical outcomes. In our experience, however, the rate of recurrent aortic insufficiency was significant, especially in patients who underwent cusp augmentation with glutaraldehyde-treated autologous pericardial patch.

Original languageEnglish
Pages (from-to)1171-1177
Number of pages7
JournalAnnals of Thoracic Surgery
Volume106
Issue number4
DOIs
StatePublished - Oct 2018

Fingerprint

Dive into the research topics of 'Pericardial Patch Augmentation Is Associated With a Higher Risk of Recurrent Aortic Insufficiency'. Together they form a unique fingerprint.

Cite this