Glutaraldehyde-Treated Autologous Pericardium in Aortic Valve Reconstruction: an Optimal Material for Innovation Techniques. Review of the Literature

Introduction. Reconstructive operations on the aortic valve (AV) offer several advantages over standard AV replacement with mechanical or biological prostheses. This approach has allowed patients to avoid the adverse effects of long-term antithrombotic therapy. Furthermore, it has preserved the natural mobility of the left ventricular outflow tract, resulting in improved hemodynamics across the valve. Materials for reconstruction are often readily available, making the method economically attractive.Problem Statement. Autologous pericardium is the most commonly used material in AV reconstruction. Glutaraldehyde treatment of autologous pericardium (GTAP) has provided tissue with enhanced mechanical properties and reduced thrombogenicity. However, the long-term degeneration of biological tissues used in AV surgery has remained a concern despite glutaraldehyde treatment.Purpose. This study has aimed to evaluate the current status and future prospects for the use of GTAP in reconstructive AV surgery.Materials and Methods. A literature search has been conducted using PubMed, Web of Science, and the Google search engine. All studies on GA-fixed pericardial tissue published up to March 2023 have been identified. A total of 165 articles have been initially retrieved, of which 20 relevant studies are included in this review. Results. GTAP has demonstrated excellent elasticity and surgical handling characteristics. It has enabled complex AV reconstructions with sustained immediate transvalvular hemodynamics. Degeneration and calcification rates of GTAP have been comparable to those observed in existing biological prostheses.Conclusions. GTAP off ers signifi cant potential for advancing techniques in aortic valve pathology correction. It is cost-effective, readily available, and facilitates effective valve reconstruction. However, aggressive prophylaxis for infective endocarditis remains mandatory in the postoperative period. Further multicenter studies with larger cohorts are essential to better delineate the long-term prospects and limitations of GTAP in AV surgery.