Aortic Root Replacement with Autologous Pericardium Valved Conduit

Available aortic prosthesis replacement options are challenged to achieve low perioperative morbidity, low pressure gradients, and prolonged durability. Trileaflet aortic valve reconstruction using autologous pericardium offers an alternative treatment option with excellent postoperative gradients, large effective orifice areas, and the avoidance of long-term anticoagulation. The modified Bentall procedure with either tissue xenograft valved conduit or mechanical valved conduit is considered the gold standard for patients with aortic root pathology requiring surgical replacement. We report a novel adaptation of the modified Bentall procedure with a self-fabricated valved conduit with trileaflet aortic valve neocuspidization using autologous pericardium. Currently available aortic prosthesis replacement options are challenged to achieve low perioperative morbidity, low pressure gradients, and prolonged durability. Trileaflet aortic valve reconstruction using autologous pericardium with the AVNeoTM system offers an alternative treatment option with excellent postoperative gradients, large effective orifice areas, and the avoidance of long-term anticoagulation1. Professor Ozaki reported excellent durability with over 95% of patients free from reoperation at 10-years1. The modified Bentall procedure with prosthesis valved conduit is considered the gold standard for patients with aortic root pathology requiring surgical replacement2. We report a novel adaptation of the modified Bentall procedure with a self-fabricated valved conduit with trileaflet aortic valve neocuspidization using autologous pericardium with the AVNeoTM system. Since the AVNeoTM template is a U.S. Food and Drug Administration approved device for treatment of aortic valve diseases1, institutional review board approval for this procedure was not necessary.