Background: Aortic valve neocuspidization (AVNeo) with autologous pericardium is a surgical treatment
option for aortic valve disease and might be beneficial for younger patients. Especially
for these patients, durability is a major factor. We analyzed outcomes of 162 patients
after AVNeo with regard to survival, freedom from reoperation and valve related events.
Methods: Patients undergoing AVNeo between 2016 to 2021 were included. Transthoracic echo
was performed prior to the operation, at discharge and annually thereafter. Data were
analyzed for incidences of structural valve deterioration, bioprosthetic valve failure,
survival, freedom from reoperation and hemodynamic performance.
Results: AVNeo was performed in 162 patients (mean age 52.6 ± 16.6 years; range: 13–78 years),
114 (70.4%) were male and 132 patients had a bicuspid aortic valve (81.5%). Leading
indication for surgery was aortic valve stenosis (126 patients, 77.8%) and in 63 patients
(38.9%) concomitant procedures were performed. Mean follow- up was 3.5 ± 1.2 years.
At discharge, peak and mean pressure gradients were 15.6 ± 7.2 and 8.4 ± 3.7 mmHg
with a mean effective orifice area (EOA) of 2.4 ± 0.8 cm². After 5 years, peak and
mean gradients were 14.5 ± 4.6 and 7.5 ± 2.2 mmHg and EOA 2.3 ± 0.8 cm². The cumulative
incidence of moderate and severe structural valve deterioration and bioprosthetic
valve failure after 5 years were 9.82% ± 3.87, 6.96% ± 3.71% and 12.1% ± 4.12%, respectively.
Survival was 97.3% ± 1.4% and freedom from reoperation 91.3% ± 2.4%.
Conclusion: Pressure gradients after AVNeo are low after the initial surgery and throughout the
study period with excellent survival in this young patient population. Main reason
for reoperation is endocarditis while rates for structural valve degeneration are
low.
