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.1A one-way street no more?
In many congenital heart centers, maybe even the majority, a neonate presenting with critical aortic stenosis will end up, without much discussion, undergoing a balloon dilation, without the benefit of a multidisciplinary discussion with the surgeons. The study in this issue of the Journal by Vergnat and colleagues1 from Sankt Augustin, Germany, a center with specific expertise in this topic, demonstrates with a data set that includes 103 neonates that open valvuloplasty resulted in less need for reoperation than did balloon valvuloplasty, especially in cases in which a tricuspid arrangement could be achieved.
