We report a case presentation of an asymptomatic 18-year-old girl with a recurrent severe aortic regurgitation and moderately dilating ventricle as a result of right cusp replacement done at 15 years of age that became necessary severe regurgitation after the performance of balloon dilatation at 3 months. A successful redo right coronary cusp replacement was implemented with a cryopreserved decellularized glutaraldehyde-treated autopericardial patch. We observed improvement in left ventricle function and a good hemodynamic profile of aortic valve at 3 years of follow-up. Autologous cryopreserved decellularized glutaraldehyde-treated pericardium appeared to facilitate aortic valve reconstruction by providing a reproducible off-the-shelf material to preclude Ross- and mechanical valve replacement-associated drawbacks for a time.

In the past decade, aortic valve (AV) repair in children with cusp prolapse has comprised cusp plication, triangular resection and then extension with autopericardium. Although these techniques have been quite reproducible, durability of AV repair (AVRep) in children with a lack of valve tissue, has been challenging with the mean time to a 50% reoperation of 4,4 years (1). In this setting, cusp replacement may occasionally be quite beneficial to allow for aortic root growth and postponement AV replacement (AVR) methods can be safely used precluding their drawbacks for a time (2). We report a successful application of redo cusp replacement to pediatric patient applying cryopreserved decellularized glutaraldehyde-treated (CDGT) autopericardium.