Congenital: Aortic Valve
Aortic valve neocuspidization: A bright future in pediatric aortic valve surgery?
We congratulate Ozaki and colleagues1 on their study evaluating midterm results after aortic valve neocuspidization (AVNeo) with glutaraldehyde-treated autologous pericardium. In their cohort of 850 adult patients with various aortic valve diseases who underwent an aortic valve replacement during a period of 8 years, excellent results were reported in terms of actuarial freedom from death, cumulative incidence of reoperation, and recurrent moderate or greater aortic regurgitation.1Aortic valve neocuspidization: Oversized shoes for children?
For adult patients, aortic valve neocuspidization (AVNeo) with glutaraldehyde-treated autologous pericardium is a very attractive option, with neither any limitation in annulus size nor any need for anticoagulation and with favorable midterm results.1 These features are enough to draw the attention of pediatric cardiac surgeons as well. In their letter, Kalfa and colleagues2 mentioned their preliminary pediatric AVNeo cases, which had been performed on children for whom the Ross procedure was unsuitable.Leaflet-base–preserving truncal valve repair with ethanol-treated autologous pericardium
Persistent truncus arteriosus requiring truncal valve surgery is associated with poor prognosis.1 Valve replacement should be avoided for neonates or young infants; however, truncal valve repair (TrVR) sparing native leaflets has limitations because leaflet tissues are often dysplastic and very fragile. Glutaraldehyde-treated pericardium, which is commonly used in adult valve surgery, has unresolved problems in terms of calcification and toxicity, especially in children. We report a novel TrVR in which we used ethanol-treated pericardium.
