Treated bovine and autologous pericardium for aortic valve reconstruction

Background. To determine the differences in clinical behavior of bovine versus autologous pericardium, all consecutive patients undergoing aortic valve reconstruction were reviewed. Methods. Between October 1988 and December 1995, 91 patients (mean age 30 years) underwent reconstruction with bovine (n = 27) or autologous (n = 64) pericardium. Results. There were 2 hospital deaths, 5 late deaths, and no embolic events. Dysfunction of the aortic reconstruction required reoperation in 6 bovine (infection 1, fibrocalcific 5) and in 5 autologous (infection 3, annulus dilatation 1, commissural tear 1). Actuarial survival and freedom from structural deterioration at 8 years were 82.2% +/- 9.6% and 76.2% +/- 10.7% for bovine and 91.05%; +/- 3.96% and 96.8% +/- 2.25% for autologous pericardium, respectively. The last Doppler echocardiographic study showed a mean regurgitation (1 to 4+) and gradient in the bovine pericardium of 1.25 +/- and 20.7 mm Hg and in the autologous pericardium of 1+ and 7.7 mm Hg. Conclusions. Aortic valve reconstruction with pericardium can be safely performed with low thromboembolic rate. At 8 years follow up, there is a difference in favor of the autologous pericardium. (C) 1998 by The Society of Thoracic Surgeons.