Background: Aortic cusp extension is a technique for aortic valve (AV)
repairs in pediatric patients. The choice of the material used in this
procedure may influence the time before reoperation is required. We
aimed to assess post-operative and long-term outcomes of patients
receiving either pericardial or synthetic repairs. Methods: We conducted
a single center, retrospective study of pediatric patients undergoing
aortic cusp extension valvuloplasty (N=38) with either autologous
pericardium (n=30) or Cormatrix (n=8) between April 2009 and July 2016.
Short and long-term postoperative outcomes were compared between the two
groups. Freedom from reoperation was compared using Kaplan Meier
analysis. Degree of aortic stenosis (AS) and aortic regurgitation (AR)
were recorded at baseline, post-operatively, and at outpatient
follow-up. Results: At five years after repair, freedom from reoperation
was significantly lower in the CorMatrix group (12.5%) compared to the
pericardium group (62.5%) (P = 0.01). For the entire cohort, there was
a statistically significant decrease in the peak trans-valvar gradient
between pre- and post-operative assessments with no significant change
at outpatient follow-up. In the pericardium group, 28 (93%) had
moderate to severe AR at baseline which improved to 11 (37%)
post-operatively and increased to 21 (70%) at time of follow-up. In the
biomaterial group, 8 (100%) had moderate to severe AR which improved to
3 (38%) post-operatively and increased to 7 (88%) at time of
follow-up. Conclusion: In terms of durability, the traditional
autologous pericardium may outperform the new CorMatrix for AV repairs
using the cusp extension method.
Effectiveness of Angiotensin-Converting Enzyme Inhibitors in Pediatric Patients with Mid to Severe Aortic Valve Regurgitation
