Abstract
INTRODUCTION: Recently, there has been a widespread use of aortic valve neocuspidization, but there is limited data regarding rheumatic heart disease. In this study, we reviewed our experience. METHODS: A total of 33 patients (22 men, 66.7%) with rheumatic aortic valve disease (mean age 39.36 ± 10.65 years) underwent aortic valve replacement between June 2019 and October 2023. RESULTS: The most common pathology was severe stenosis (14 patients, 42.4%), with bicuspid morphology in 11 patients (33.3%). The mean cardiopulmonary bypass and aortic cross-clamping times were 151 ± 24.26 and 127 ± 21.05 minutes, respectively. There was no perioperative mortality. One patient who developed significant aortic regurgitation underwent valve replacement prior to discharge. The pre-discharge average peak/mean gradients were 12 ± 3.7/6 ± 2 mmHg, respectively. Follow-up was complete (mean: 31.54 ± 12.94 months). There were two late mortalities (6%), one due to endocarditis and another due to coronavirus disease. One patient (3%) needed a permanent pacemaker one year later. Overall survival at one, two, and four years were 97%, 97%, and 94% respectively, and freedom from reoperation was consistent at 97%. The peak/mean gradients remained low at one and three years (12 ± 2.7 mmHg/4.8 ± 1.7 mmHg and 10.14 ± 4.02/4.4 ± 2.3 mmHg, respectively). Overall four-year freedom from at least moderate regurgitation was 97%. CONCLUSION: Our data shows promising results for this procedure in rheumatic pathology. The hemodynamic data is satisfactory and the earlyto mid-term results are encouraging; however, long-term data is needed to determine durability.