Autologous pericardium: A bright future in pediatric aortic valve surgery?

Background: At present, the majority of aortic valve diseases have been traditionally treated by prosthetic valve replacement, whether using a mechanical or a bio-prosthetic valve. Surgical management of aortic valve disease in pediatric patients is still a great challenge, especially the surgical timing, selection of surgical approach, and optimal surgical materials. Aim of Review: In this paper, the main perspective is to propose the use of an aortic stent coating with endothelial cells and smooth muscle cells on both sides as aortic valve in the Ozaki procedure. Owing to its good biocompatibility, stability, thin but high tensile strength, anti-calcification, anticoagulant properties, and rapid endothelialization in vivo, long-term results from that instead of autologous pericardium in the Ozaki procedure may be superior to Ross in pediatric patients. Key Scientific Concepts of Review: The key scientific concepts are as follows: (1) a one-step, rapid, and robust concept for the preparation of aortic stent coating with endothelial cells and smooth muscle cells, and (2) Ozaki procedure.