Author + information
- Meena Nathana,b,
- Rebecca Beroukhima,b,
- Kimberlee Gauvreaua,b,
- Ann Demeritta,b,
- Edward Marcusa,b,
- Tal Gevaa,b,
- Christopher Bairda,b and
- Pedro del Nidoa,b
Background: While aortic valve repair (AoVR) is considered the most appropriate therapy in pediatric population, mid/long term outcomes have been disappointing from progressive dysfunction of currently available leaflet substitute material. We aim to compare outcomes of AoVR with autologous pericardium (AP) vs, porcine intestinal submucosa- CorMatrix(CM)
Methods: Consecutive patients from 2008 to 2010 who underwent AoVR (full/partial leaflet replacement, edge augmentation, leaflet patch, predominantly in single leaflet) were studied. Clinical and echo data (read in corelab by 2 readers) were collected preoperatively, at discharge and for up to 5 years post discharge. Time to reintervention (RI) was analyzed by cox regression. Progression of aortic regurgitation (AR) and stenosis (AS) was compared between AP and CM from discharge to latest followup.
Results: There were 26 CM and 49 AP patients followed for a median of 3.2 (IQR 0.9, 5) years. Baseline characteristics were similar between groups. There were 12 (46%) RI in CM vs.13 (27%) in AP group. On univariable analysis, age, weight, and CM use predicted RI. On multivariable modeling CM had a shorter time to RI (HR 3.5, CI 1.5, 7.8; p=0.003) adjusted for age and type of leaflet repair (figure).
Conclusions: Aortic valve repair with CM is associated with earlier time to reintervention. In the current era, autologous pericardium remains the best alternative for AoVR. The search for replacement material, particularly those with growth potential continues.
Room 146 C
Sunday, March 19, 2017, 8:51 a.m.-9:01 a.m.
Session Title: Highlighted Original Research: Congenital Heart Disease and the Year in Review
Abstract Category: 10. Congenital Heart Disease: Pediatric
Presentation Number: 908-10
- 2017 American College of Cardiology Foundation