| Title: |
Cylinder Bicuspid Pulmonary Valve Reconstruction Using Equine Pericardium: A Novel Technique for Right Ventricular Outflow Tract Repair |
| Authors: |
Ahmed F. Elmahrouk; Abdelmonem M. Helal; Mohammad F. Babgi; Abdulbadee Bogis; Amjad A. Kouatli; Mohammad S. Shihata |
| Source: |
Journal of Clinical Medicine ; Volume 15 ; Issue 4 ; Pages: 1457 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
pulmonary hypoplasia; pulmonary atresia; right ventricular outflow tract obstruction |
| Description: |
Background: Right ventricular outflow tract (RVOT) reconstruction is frequently performed for pediatric patients with pulmonary valve anomalies, yet optimal techniques remain debated. The equine pericardium offers a promising substrate for pulmonary valve reconstruction but has been understudied in pulmonary valve reconstruction. This study evaluated a novel technique using the equine pericardium to create a cylinder bicuspid pulmonary valve for RVOT reconstruction. Methods: In this retrospective cohort study, 17 pediatric patients (median age: 10 months; 53% male) underwent RVOT reconstruction with equine pericardium between 2023 and 2024. The valve was fashioned from a patch of equine pericardium into a cylinder to create a functionally bicuspid valve. The height of the cylinder ranged from 1.5–2 cm. The diameter was measured around a Hegar dilator corresponding to a valve size z-score of +3. The outcomes included the degree of postoperative pulmonary regurgitation, RVOT pressure gradients, postoperative complications, and reinterventions. Results: Postoperatively, the median peak RVOT pressure gradient decreased significantly from 70 mmHg (IQR: 65–90) to 25 mmHg (IQR: 20–40; p < 0.001). Mild pulmonary regurgitation persisted in one patient (5.9%). Five patients had mild right ventricular dysfunction (29.41%). At a median 3-month follow-up (IQR: 1–8), 17.7% (n = 3) underwent cardiac catheterization. There was no postoperative mortality. Conclusions: Cylinder bicuspid pulmonary valve reconstruction using the equine pericardium effectively reduces RVOT obstruction while maintaining pulmonary valve competence and demonstrates acceptable short-term safety. Having a competent pulmonary valve after repairing the hypoplastic pulmonary valve annulus is very promising; however, the small cohort and limited follow-up preclude definitive conclusions about long-term durability. Larger prospective studies with longer follow-up periods are needed to validate this technique for RVOT reconstruction. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
General Surgery; https://dx.doi.org/10.3390/jcm15041457 |
| DOI: |
10.3390/jcm15041457 |
| Availability: |
https://doi.org/10.3390/jcm15041457 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.89D5F0F9 |
| Database: |
BASE |