Long-Term Results of Pericardial Autologous Patch Enlargement of the Aortic Annulus Using the Manouguian Technique

Authors

  • Orhan Saïm Demïrtürk Başkent University Adana Medical Center, Department of Cardiouvascular Surgery, Adana
  • H.Tarik Kiziltan Özel Adana Hastanesi Seyhan, Adana
  • İsa Coşkun Başkent University Adana Medical Center, Department of Cardiouvascular Surgery, Adana
  • Hüseyin Ali Tünel Başkent University Adana Medical Center, Department of Cardiouvascular Surgery, Adana
  • Hatice Göknur Tekin Başkent University Adana Medical Center, Department of Cardiology, Adana

DOI:

https://doi.org/10.1532/hsf.1258

Abstract

Background: The management of a small aortic root at the time of aortic valve replacement is controversial. In cases in which the aortic root is very small the choice of aortic valve type and of root-enlargement method is difficult. The technical challenge of the small aortic root has instigated the creation of methods for annular enlargement. Severe mismatch as a predictor of overall 30-day mortality or midterm mortality reports about long-term results of aortic valve replacement using autologous pericardial patch are scarce. Moreover, no reports about patient series are present in the English medical literature. This retrospective study was designed to address this gap in evidence.
Methods: Twenty consecutive patients undergoing aortic valve replacement (with or without mitral valve replacement and/or coronary artery bypass grafting) at Başkent University Adana Medical Center between June 30, 1999 and April 10, 2006 were retrospectively evaluated. All clinical and echocardiographical data belonging to this population were specified. Their perioperational data were assessed.
Results: Twenty patients operated using the Manouguian technique for narrow aortic root from June 1999 to April 2006 were followed for 8.54 ± 3.35 years. Fourteen patients were alive at the end of the follow-up. Six patients had died. Early mortality rate was 5% and late mortality after 8.54 ± 3.35 years was 30%. Late mortality related to cardiac reasons was 5%. Only one death could be attributed to a cardiac cause which occured in a 36-year-old male patient 3 years and 6 months after the operation. 70% of the patients were alive after a mean follow-up period of 8.54 ± 3.35 years.
Conclusion: The main finding of the present study is that aortic root enlargement using untreated fresh autologous pericardium in Manouguian type operations is a durable option, especially in conditions when homograft or stentless valve use is difficult or economically not feasible. We found that no patient had aneurysmal dilatation or mitral regurgitation after a mean follow-up of 8.54 ± 3.35 years with autologous untreated pericardium as the enlargement patch.

Author Biographies

Orhan Saïm Demïrtürk, Başkent University Adana Medical Center, Department of Cardiouvascular Surgery, Adana

DEPARTMENT OF CARDIOVASCULAR SURGERY

ASSOCIATE SURGERY

H.Tarik Kiziltan, Özel Adana Hastanesi Seyhan, Adana

ASSOCIATE PROFESSOR OF CARDIOVASCULAR SURGERY

İsa Coşkun, Başkent University Adana Medical Center, Department of Cardiouvascular Surgery, Adana

ASSOCIATE PROFESSOR OF SURGERY

Hüseyin Ali Tünel, Başkent University Adana Medical Center, Department of Cardiouvascular Surgery, Adana

ASSISTANT PROFESSOR OF SURGERY

Hatice Göknur Tekin, Başkent University Adana Medical Center, Department of Cardiology, Adana

ASSOCIATE PROFESSOR OF CARDIOLOGY

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Published

2016-04-05

How to Cite

Demïrtürk, O. S., Kiziltan, H., Coşkun, İsa, Tünel, H. A., & Tekin, H. G. (2016). Long-Term Results of Pericardial Autologous Patch Enlargement of the Aortic Annulus Using the Manouguian Technique. The Heart Surgery Forum, 19(2), E067-E073. https://doi.org/10.1532/hsf.1258

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