Key result
Autologous pericardial aortic valve neocuspidization shows early structural deterioration with leaflet tears at 27 months.
Why the study?
Although AVNeo with autologous pericardium has shown excellent medium-term results, early structural valve deterioration such as leaflet tear and perforations had not been reported.
Case Report (n=1)
Aortic valve neocuspidization with autologous pericardium can be complicated by early structural valve deterioration such as leaflet tear and perforations.
May signal need for post-AVNeo surveillance; hypothesis-generating and requires confirmation in larger cohorts before practice implications.
Although aortic valve (AV) replacement is a curative procedure for severe aortic stenosis, prosthetic heart valves have many disadvantages and cause serious complications. A new promising surgical procedure-aortic valve neocuspidization (AVNeo)-has recently been developed; it is an original method of AV reconstruction with autologous pericardium. It has been reported to yield excellent medium-term results with respect to durability and complications. Herein, we encountered a first case of AV leaflet tear and perforations 27 months after AVNeo using autologous pericardium. AV leaflet tear or perforation is well recognized as a long-term serious complication of pericardial xenografts. Interestingly, however, AVNeo caused early structural valve deterioration in the current case. In the present case, an eccentric aortic regurgitation jet observed on colour flow imaging led us to reach the correct diagnosis. Finally, the patient showed complete recovery with redo AV replacement. This case highlights the importance of understanding the potential pitfalls of this new surgical technique and that of colour Doppler echocardiography in reaching a definite diagnosis.
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Makino et al. (2019) conducted a case report in Aortic valve leaflet tear and perforations after neocuspidization (n=1). Aortic valve neocuspidization (AVNeo) with autologous pericardium was evaluated on Aortic valve leaflet tear and perforations. Aortic valve neocuspidization with autologous pericardium resulted in early structural valve deterioration, specifically leaflet tear and perforations, at 27 months post-procedure.