Clinical Study Of Autologous Pericardium In Repairing Aortic Insufficiency Caused By Severe Single Leaflet Disease In Children

ObjectiveTo investigate the clinical efficacy and near-term follow-up results of autologous pericardial in repairing aortic insufficiency caused by severe single leaflet disease(such as ventricular septal defect combined with severe prolapse of single leaflet with or without leaflet contracture,thickening of the valve;infective endocarditis with large single leaflet perforation,perforation area is greater than 50% of leaflet area)in children.MethodThis study used a retrospective statistical analysis method.Taking advantage of the clinical medical record management system of the First Affiliated Hospital of Zhengzhou University.The clinical data of 21 children with aortic insufficiency caused by severe single leaflet disease were collected from January 2015 to January 2018.Record the results of preoperative and postoperative echocardiography results.The symptoms and signs,echocardiography results,adverse events(recurrent aortic insufficiency event,valve-related infective endocarditis event,thromboembolic event)were recorded during the follow-up period.The paired t-test was used to compare the pre-and post-operative measurement data of the children.P < 0.05 was considered statistically significant.ResultsThere were no deaths and surgical complications during the postoperative hospital stay.Immediately after the re-explosion,transesophageal echocardiography shows normal structure and function of aortic valve leaflets after repair.All patients were followed up regularly,without loss of follow-up,followed up for 12 to 48 months,mean(32 ± 7)months,no deaths and requiring secondary surgery events during the follow-up period.No other adverse events(recurrent aortic regurgitation,valve-related infective endocarditis,thromboembolic events,etc.)occurred.Postoperative cardiac function was restored to NYHA class I.Postoperative left ventricular end-diastolic diameter,left ventricular ejection fraction and cardiothoracic ratio were significantly improved(P<0.05).During the follow-up period,echocardiography showed no structural deterioration of leaflet fibrosis,calcification,contracture,etc.There were 2 cases in which the amplitude of pericardial valve leaflet motion was stiff at the 18 th and 24 th months of follow-up,but the overall leaflet opening area was acceptable.ConclusionThe near and medium term of autologous pericardium repairs aortic insufficiency caused by severe single leaflet disease in children is satisfactory.The surgery is highly repeatability with a low risk,and the long-term effect is to be further followed up.To a certain extent,it can delay the timing of aortic valve replacement in children.Therefore,it can effectively avoid the higher surgical risk and more postoperative complications associated with valve replacement,aortic root enlargement and the Ross procedure.