Background Aortic valve replacement with mechanical valves is the standard treatment for aortic valve disease in Indonesia. Its usage is associated with high cost, risk of endocarditis and thromboembolic event, and lifetime consumption of anticoagulants. We performed a novel replacement technique of the aortic valve using an autologous pericardium and evaluated the short-term outcomes.

Methods From April 2017 to April 2020, 16 patients underwent aortic valve replacement with a single-strip autologous pericardium. Outcomes of the left ventricular reverse remodeling (LVRR), 6-minute walk test (6MWT), and soluble suppression of tumorigenicity-2 (sST-2) were measured at 6 months postoperation.

Results A total of 16 surgeries were performed using aortic valve replacement with single-strip pericardium without conversion to mechanical valve replacement. The patients included eight males and eight females, and the mean age was 49.63 ± 12.54 years. The most common diagnosis was mixed aortic valve stenosis and regurgitation (9 cases). Five patients underwent a concomitant coronary artery bypass graft (CABG) procedure and 12 patients underwent either mitral or tricuspid valve repair. The mean aortic cross-clamp time was 139.88 ± 23.21 minutes and cardiopulmonary bypass time was 174.37 ± 33.53 minutes. At 6 months postoperation, there was an increase in the distance walked at the 6MWT (p = 0.006) and a decrease of the sST-2 level (p = 0.098). Echocardiogram showed two patients had LVRR. Survival and freedom from reoperation are 100% at 1 year of follow-up.

Conclusion Aortic valve replacement with a single strip of pericardium is a good alternative to aortic valve replacement with a mechanical valve. Short-term evaluation at 6 months postoperation showed improvement in clinical status and echocardiographic parameters compared to baseline.

背景 用机械瓣膜置换主动脉瓣是印度尼西亚主动脉瓣疾病的标准治疗方法。其使用与高成本、心内膜炎和血栓栓塞事件的风险以及抗凝剂的终生消耗有关。我们使用自体心包进行了一种新颖的主动脉瓣置换技术，并评估了短期结果。

方法 2017年4月至2020年4月，16例患者接受单条自体心包主动脉瓣置换术。术后6个月测量左心室逆重塑（LVRR）、6分钟步行试验（6MWT）和可溶性致瘤性抑制-2（sST-2）的结果。

结果 共有16例手术采用单条心包主动脉瓣置换术，未中转机械瓣膜置换术。患者包括8名男性和8名女性，平均年龄为49.63±12.54岁。最常见的诊断是混合性主动脉瓣狭窄和反流（9例）。5 名患者接受了同步冠状动脉旁路移植术 (CABG) 手术，12 名患者接受了二尖瓣或三尖瓣修复术。平均主动脉阻断时间为 139.88 ± 23.21 分钟，体外循环时间为 174.37 ± 33.53 分钟。术后 6 个月，6MWT 行走距离增加 ( p  = 0.006)，sST-2 水平下降 ( p = 0.006) = 0.098）。超声心动图显示两名患者有 LVRR。随访 1 年时，存活率和免再手术率为 100%。

结论 单条心包膜置换主动脉瓣是机械瓣膜主动脉瓣置换的良好替代方案。术后 6 个月的短期评估显示，与基线相比，临床状态和超声心动图参数有所改善。