Document Detail


Clinical experience with expanded use of the Ross procedure: a paradigm shift?
MedLine Citation:
PMID:  20583389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: The study aim was to evaluate the short-term survival and functional outcome after the Ross procedure, with expanded inclusion criteria. METHODS: A total of 91 patients (21 females, 70 males; mean age 57.3 +/- 13.1 years; range: 0.1-74 years) underwent aortic valve replacement (AVR) with a Ross procedure at the authors' institution during the year 2007. The underlying valve diseases were stenosis in 60 patients, regurgitation in 17, and a mixed lesion in 14. Seven patients suffered from acute infective endocarditis, and in five patients the Ross operation was a reoperative procedure. Forty-four patients (48%) underwent surgery in association with concomitant procedures, which included predominantly coronary artery bypass surgery, mitral valve repair or replacement, or procedures of the ascending aorta. RESULTS: The mean cardiopulmonary bypass and aortic cross-clamp times were 147 +/- 31 min (range: 87-246 min) and 124 +/- 26 min (range: 73-195 min), respectively. Hospital mortality was 2.2%. No patient died during the follow up period. The aortic gradient was decreased from 5.1 +/- 2 mmHg at discharge, to 3.2 +/- 1 mmHg during follow up (p < 0.05); at the same times, the mean gradient of the decellularized tissue-engineered pulmonary valve was 2.8 +/- 1 mmHg and 2.7 +/- 1 mmHg, respectively. An echocardiographic examination of neo-aortic valve competence at 12 months revealed no or trivial aortic valve regurgitation in 80 patients, and mild (grade 1+) regurgitation in nine patients. No patient required reoperation of the autograft during follow up. Two patients underwent reconstruction of the right ventricular outflow tract. At 12 months' follow up, all patients enjoyed normal social interactions, were in NYHA functional class I or II, and free from complications. CONCLUSION: The Ross procedure can be offered as an alternative to standard prosthetic AVR with an excellent short-term outcome. The former inclusion/exclusion criteria for this procedure should be re-evaluated.
Authors:
Alexander Weymann; Pascal M Dohmen; Herko Grubitzsch; Simon Dushe; Sebastian Holinski; Wolfgang Konertz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  19     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-29     Completed Date:  2010-07-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  279-85     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Charité - University Medicine Berlin, Campus Charité Mitte, Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aortic Valve Insufficiency / surgery
Aortic Valve Stenosis / surgery
Bioprosthesis
Child
Child, Preschool
Female
Heart Valve Diseases / surgery*
Hospital Mortality
Humans
Infant
Male
Middle Aged
Patient Selection
Prospective Studies
Pulmonary Valve / transplantation*
Reconstructive Surgical Procedures
Suture Techniques
Tissue Engineering
Transplantation, Autologous
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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