Abstract
Patch enlargement of the aortic root or anulus is a widely accepted technique when restrictive anatomy is encountered during aortic valve replacement. Patches made of prosthetic material have been used almost exclusively, and patches of autogenous pericardium have not received wide acceptance. Although pericardium is advantageous because of its low cost, ready availability, and ease of handling, its long-term durability has not been fully established. From 1965 to 1981, 96 patients had autogenous pericardial patches placed during aortic valve replacement at the Mayo Clinic. In 81 patients, the patches were placed solely in a supravalvular position to facilitate aortic closure, while in 15 patients the patches were placed in both subvalvular and supravalvular positions, allowing for annular expansion and insertion of a larger prosthesis. In a mean follow-up of 5.4 years, none of the 92 operative survivors has had clinical evidence of sudden patch failure and none has had patch aneurysms detected by routine chest roentgenography. One patient required reoperation for a perivalvular leak at the point where the prosthesis had been sutured to the patch. Objective data concerning the late postoperative status of the patch were available on 48 patients: 24 underwent reoperation, 16 underwent two-dimensional echocardiography, two underwent aortic root angiography, and six underwent postmortem examination. Patch aneurysms were universally absent, and in every patient the patches were well incorporated into the adjacent tissues. This proven durability suggests that autogenous pericardium is a satisfactory patch material when required during aortic valve replacement.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 350-358 |
| Number of pages | 9 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 86 |
| Issue number | 3 |
| State | Published - 1983 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
Enlargement of the aortic root or anulus with autogenous pericardial patch during aortic valve replacement. Long-term follow-up. / Piehler, J. M.; Danielson, G. K.; Pluth, J. R.; Orszulak, T. A.; Puga, F. J.; Schaff, Hartzell V; Edwards, W. D.; Shub, C.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 86, No. 3, 1983, p. 350-358.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Enlargement of the aortic root or anulus with autogenous pericardial patch during aortic valve replacement. Long-term follow-up
AU - Piehler, J. M.
AU - Danielson, G. K.
AU - Pluth, J. R.
AU - Orszulak, T. A.
AU - Puga, F. J.
AU - Schaff, Hartzell V
AU - Edwards, W. D.
AU - Shub, C.
PY - 1983
Y1 - 1983
N2 - Patch enlargement of the aortic root or anulus is a widely accepted technique when restrictive anatomy is encountered during aortic valve replacement. Patches made of prosthetic material have been used almost exclusively, and patches of autogenous pericardium have not received wide acceptance. Although pericardium is advantageous because of its low cost, ready availability, and ease of handling, its long-term durability has not been fully established. From 1965 to 1981, 96 patients had autogenous pericardial patches placed during aortic valve replacement at the Mayo Clinic. In 81 patients, the patches were placed solely in a supravalvular position to facilitate aortic closure, while in 15 patients the patches were placed in both subvalvular and supravalvular positions, allowing for annular expansion and insertion of a larger prosthesis. In a mean follow-up of 5.4 years, none of the 92 operative survivors has had clinical evidence of sudden patch failure and none has had patch aneurysms detected by routine chest roentgenography. One patient required reoperation for a perivalvular leak at the point where the prosthesis had been sutured to the patch. Objective data concerning the late postoperative status of the patch were available on 48 patients: 24 underwent reoperation, 16 underwent two-dimensional echocardiography, two underwent aortic root angiography, and six underwent postmortem examination. Patch aneurysms were universally absent, and in every patient the patches were well incorporated into the adjacent tissues. This proven durability suggests that autogenous pericardium is a satisfactory patch material when required during aortic valve replacement.
AB - Patch enlargement of the aortic root or anulus is a widely accepted technique when restrictive anatomy is encountered during aortic valve replacement. Patches made of prosthetic material have been used almost exclusively, and patches of autogenous pericardium have not received wide acceptance. Although pericardium is advantageous because of its low cost, ready availability, and ease of handling, its long-term durability has not been fully established. From 1965 to 1981, 96 patients had autogenous pericardial patches placed during aortic valve replacement at the Mayo Clinic. In 81 patients, the patches were placed solely in a supravalvular position to facilitate aortic closure, while in 15 patients the patches were placed in both subvalvular and supravalvular positions, allowing for annular expansion and insertion of a larger prosthesis. In a mean follow-up of 5.4 years, none of the 92 operative survivors has had clinical evidence of sudden patch failure and none has had patch aneurysms detected by routine chest roentgenography. One patient required reoperation for a perivalvular leak at the point where the prosthesis had been sutured to the patch. Objective data concerning the late postoperative status of the patch were available on 48 patients: 24 underwent reoperation, 16 underwent two-dimensional echocardiography, two underwent aortic root angiography, and six underwent postmortem examination. Patch aneurysms were universally absent, and in every patient the patches were well incorporated into the adjacent tissues. This proven durability suggests that autogenous pericardium is a satisfactory patch material when required during aortic valve replacement.
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UR - http://www.scopus.com/inward/citedby.url?scp=0020618589&partnerID=8YFLogxK
M3 - Article
C2 - 6887955
AN - SCOPUS:0020618589
VL - 86
SP - 350
EP - 358
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 3
ER -