Title: Abstracts of the 68th Annual Conference of IACTS, April 2022
Abstract: BackgroundIt is not uncommon to see children who have been followed up for small subpulmonic ventricular septal defects develop moderate to severe aortic regurgitation.The repair has to be tailored to the aortic valve pathology.We propose leaflet extension as a reproducible technique in which prolapse of the valve is associated with retraction reducing the geometric height of the leaflets.Methods 3 patients with severe AR with VSD were repaired by using a single leaflet extension technique using autologous glutaraldehyde fixed pericardium (0.6% for 10 minutes followed by 18 minutes washing for 3 times each for 6 min duration).All three had moderate to severe AR requiring ostial plegia for cardiac arrest.The prolapsed free margin was extended using glutaraldehyde fixed pericardium using 7-0 prolene sutures and the commissure was resuspended on either side using a separate 6-0 prolene pledgetted suture fixed outside the aortic wall. ResultsAll three had no aortic regurgitation at the end of the procedure.The period of follow up is from one month to one year.The immediate postoperative and early follow up results have been good with no aortic regurgitation developing. ConclusionEarly results of leaflet extension which is built up on the principle of single leaflet Ozaki reconstruction has been good.Too much redundancy of the leaflet needs to be avoided to avoid buckling and obstruction to coronary ostia.Longer-term follow up is necessary to assess the durability of this repair technique.