NOVEL AORTIC VALVE LEAFLET RECONSTRUCTION GUIDED BY 3D-VR ANALYSIS ak-sato@dmgmori.co.jp

462-05

NOVEL AORTIC VALVE LEAFLET RECONSTRUCTION GUIDED BY 3D-VR ANALYSIS

3

Japan

Oral or Poster

Aortic valve reconstruction using three same-sized leaflets have been performed for strictly selected patients. We evaluated the aortic root using novel 3D workstation to establish this procedure as reproducible technique. We followed up hemodynamic data to clarify the durability of this technique.

Basic technique: 1) Autologous or bovine pericardium were tailored using unique templates based on STJ diameters. 2) Each leaflet was sutured to the aortic annuls following to additional root adjustments when 3DVR analysis revealed abnormality of the aortic root. 3) Coaptation stitch was place on each commissure. All candidates had preoperative cardiac CT and VR analysis was applied for cases with unbalanced aortic root. All patients were followed up by ultrasound cardiography every one year after the surgery.

Since 2016, we had 54 cases, which were 5 bicuspid aortic valve and 7 acute active endocarditis. We performed additional Valsalva Procedures in 12 patients. Five of them were Bicuspid cases. One redo AVR due to leaflet perforation. The longest follow up period was 8.7 years, resulting No IE, No AR or structural problems with mean PG of 11.7mmHg.

This technique has possibility to provide a simple and reproducible procedure that allows anatomical physiologic correction of the aortic root. VR image analysis was useful to decide surgical plan for difficult cases.