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

What the procedure involves

Under general anaesthesia, access to the heart is achieved by a full or partial sternotomy and the patient is established on cardiopulmonary bypass. The heart is stopped with cardioplegic arrest. A portion of pericardium is harvested, and excessive adipose tissue removed. The excised pericardium is treated with glutaraldehyde and rinsed with saline to avoid drying. The aorta is opened and the valve is inspected. The diseased valve cusps are carefully removed. The intercommissural distances are measured using Ozaki sizers and the treated pericardium is trimmed to the desired size and stitched to the annulus to replace the removed valve leaflet(s). When aligned, the leaflets are stitched to the wall of the aorta to create a functional valve. The aorta is closed, the heart is de-aired and cardiopulmonary bypass is discontinued. The circulation is restored, and the chest closed. The function of the valve is assessed intraoperatively by transoesophageal echocardiography.