Interventional procedure overview of aortic valve reconstruction using glutaraldehyde-treated autologous pericardium for aortic valve disease

Indications and current treatment

Aortic valve disease (stenosis or regurgitation) is usually progressive, causing an increase in cardiac workload, left ventricular hypertrophy and heart failure. Symptoms can include palpitations, fatigue, shortness of breath, syncope and chest pain on exertion. Mortality rates are high in symptomatic patients.

Conventional treatment for a significantly diseased aortic valve is surgical replacement with an artificial (biological or mechanical) prosthesis or transcatheter aortic valve implantation (TAVI) with a biological prosthesis. Bioprosthetic and mechanical valves do not perform as well as native valves and have limited durability (mechanical valves last longer than bioprosthetic valves), which may be an issue for younger patients. At present, lifelong anticoagulation is required in patients with mechanical valves. This increases the risk of haemorrhagic complications particularly in older patients and those with significant comorbidities. It is also not optimal in women wishing to become pregnant.

In some patients with aortic regurgitation the aortic valve may be repaired with patches as an alternative to replacement.

The aortic valve reconstruction using glutaraldehyde-treated autologous pericardium is suitable for patients who cannot or do not wish to take anticoagulation, patients with an aorta too narrow for a standard prosthetic valve and young patients who wish to avoid long-term anticoagulation.