Aortic valve leaflet replacement using autopericardium as an alternative approach of aortic valve stenosis treatment: literature review

Abstract

Regarding degenerative defects of the aortic valve, the main method of treatment is dissection of malformed leaflets and placement of prosthetic valve. In most cases, mechanical and biological prostheses are used. Each type of prosthesis has shortcomings related to both the implantation technique and essential medication support to keep it functioning. Patients with implanted mechanical prosthesis need lifelong anticoagulation therapy and constant monitoring of blood coagulation rates, where on the one hand there is a risk of occurring thromboembolic complications, and on the other hand haemorrhagic complications. The peculiarity of biological prostheses is a high probability of degeneration and the need for re-operation, especially in young patients, therefore the implantation of such prostheses is mainly carried out in elderly patients. Despite continuous change and modification of artificial valves, the ideal aortic valve prosthesis does not exist today. Various attempts to replace aortic valve leaflets with artificial and biological materials have not succeeded or gained great recognition. In 2007, Shigeyuki Ozaki introduced a technique to replace the aortic valve leaflets with an autopericardium treated with 0.6 % glutar aldehyde solution. Inspite of the encouraging mid-term results, this surgery has not yet become widespread among cardiac surgeons due to the complicated operating technique and lack of long-term results. Considering the research of literature, experience of different cardiosurgical centers in this field as well as our own experience, there is a need to systematize the results of Ozaki procedure, among patients with aortic valve pathology, presented in the recent publications.