Autologous pericardial patch leaflet augmentation in the setting of mitral valve repair

Abstract

Mitral valve repair is the standard of care for correction of significant mitral regurgitation for a wide range of etiologies as it confers a significant survival advantage in selected patients, has demonstrated equivalent or superior durability compared to bioprosthetic replacement particularly in young patients, reduces the thromboembolic complications of mechanical replacement, and avoids the need for anticoagulation. Leaflet augmentation with glutaraldehydefixed autologous pericardium is a useful adjunct when there is insufficient leaflet tissue to produce a reliable repair using standard techniques, as it is a cheap and readily available substrate with excellent resistance to infection and calcific degeneration. Autologous pericardial patch augmentation has been described in the setting of rheumatic mitral insufficiency, ischemic mitral regurgitation, endocarditis, congenital mitral valve disease, and re-repair. Here, we provide a brief overview of the historical background, a technical description of our approach to mitral valve repair requiring pericardial patch leaflet augmentation, followed by a summary of the operative technique and results reported according to etiology.