Aortic Valve-Sparing Repair with Autologous Pericardial Leaflet Extension Has Low Long-Term Mortality and Reoperation Rates in Children and Adults

Complex aortic valve repair following excision of a papillary fibroelastoma

Complex aortic valve repair after mass lesion resection, in an otherwise normal, thin leafleted valve, is rarely described in the literature. We present a 68-year-old woman who underwent resection of an asymptomatic aortic valve papillary fibroelastoma. Due to extensive involvement of her left coronary cusp, the resection resulted in a significant defect in the leaflet, requiring a complex repair to preserve her otherwise normal aortic valve. We describe the operative findings, repair technique, and associated literature.

Aortic valve repair for congenital and balloon-induced aortic regurgitation

Current techniques for aortic valve replacement in the child carry multiple disadvantages. Longer-term follow-up of the Ross procedure has documented disappointing late results for an increasing proportion of patients. Many challenges continue to face the development of a tissue-engineered valve with growth potential. In this setting, aortic valve repair is a useful temporizing procedure that allows a child to have an excellent quality of life, free from the need for anticoagulation and the risk of thromboembolism. Repair techniques are primarily based on the use of autologous pericardium to extend leaflets and support prolapsing leaflets. These methods appear to be particularly applicable in the setting of balloon-induced aortic valve regurgitation. An increasing number of centers are reporting satisfactory midterm results with aortic valve repair.