Document Detail

Does the pulmonary autograft in the aortic position in adults increase in diameter? An echocardiographic study.
MedLine Citation:
PMID:  9104975     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of this study was to discern the fate of the pulmonary autograft diameter over time in adults and its relation to aortic regurgitation in the setting of aortic root replacement. METHODS: From January 1989 to May 1995, 36 consecutive adult patients underwent aortic root replacement with a pulmonary autograft for aortic valve disease. The mean age of 20 male and 16 female patients was 29.1 years (range 19.3 to 52.1 years). The mean follow-up was 2.3 years (range 0.3 to 6.0 years). Two patients died in the hospital. One other patient had a second operation for stenosis at the distal suture line of the allograft in the pulmonary position. Pulmonary autograft anulus and sinus diameters were measured with epicardial echocardiography before (only anulus) and after cardiopulmonary bypass, with transthoracic echocardiography at hospital discharge, and with transesophageal echocardiography during follow-up. RESULTS: The mean autograft anulus diameter did not increase immediately after cardiopulmonary bypass (mean diameter 26.2 mm before and 26.4 mm after cardiopulmonary bypass). The mean autograft sinus diameter after cardiopulmonary bypass was 36.5 mm. The mean autograft anulus diameter increased to 31.5 mm at follow-up, an increase of 5.1 mm (19%). The mean autograft sinus diameter increased to 43.9 mm at follow-up, an increase of 7.4 mm (20%). Fifty-nine percent of the anulus diameter increase and 40% of the sinus diameter increase was already reached at hospital discharge (7 to 10 days after the operation); the other part of the increase occurred during follow-up. Diameter increase was associated with neither the length of follow-up (follow-up less than 1 year compared with a longer follow-up) or severity of aortic regurgitation. CONCLUSION: Pulmonary autograft anulus and sinus diameters increase the first year after aortic root replacement with a pulmonary autograft. This occurs rapidly within 10 days after the operation, with a further increase during follow-up, without causing significant aortic regurgitation at medium-term follow-up.
R B Hokken; A J Bogers; M A Taams; M B Schiks-Berghourt; L A van Herwerden; J R Roelandt; E Bos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  113     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-01     Completed Date:  1997-05-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  667-74     Citation Subset:  AIM; IM    
Department of Cardiopulmonary Surgery, University Hospital Sophia-Dijkzigt, Rotterdam, The Netherlands.
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MeSH Terms
Age Factors
Aortic Valve Insufficiency / surgery*
Aortic Valve Stenosis / surgery*
Echocardiography, Transesophageal
Follow-Up Studies
Hospital Mortality
Middle Aged
Pulmonary Valve / pathology*,  transplantation*,  ultrasonography
Time Factors
Transplantation, Autologous

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