Document Detail

Midterm echocardiographic follow-up after Ross operation.
MedLine Citation:
PMID:  11082355     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The pulmonary autograft (Ross) operation is an attractive treatment for aortic valve disease, but hemodynamic follow-up is not well defined. METHODS AND RESULTS: One hundred thirty-two consecutive patients (62% male, mean age 40+/-11 years) were followed up to 5 years after the Ross operation. Echocardiography was performed early (within 30 days), 3 to 6 months, and yearly after surgery. The valve effective orifice area (EOA) and mean transvalvular gradient of both aortic and pulmonary valves were measured, and transvalvular regurgitation was assessed by using color Doppler echocardiography. EOA was indexed for body surface area. The hemodynamic performance was excellent for both the aortic and pulmonary valves early after surgery (gradient, 3+/-4 and 3+/-4 mm Hg, respectively). It remained stable thereafter for the aortic valve, whereas there was a significant deterioration of the EOA (-0. 74+/-0.82 cm(2)) and gradient (+6+/-8 mm Hg) for the pulmonary valve, which occurred mostly during the first 6 months after surgery. This hemodynamic deterioration resulted in suboptimal (defined as an EOA index <0.85 cm(2)/m(2)) hemodynamics in 19.3% of the patients, to the extent that 3 (2%) of the 132 patients eventually had to be subjected to further surgery for severe pulmonary valve stenosis. CONCLUSIONS: The pulmonary autograft provides continued excellent hemodynamics in the aortic position, whereas moderately high gradients can be found across the pulmonary homograft in some patients. Further studies are necessary to identify the factors responsible for the deterioration of the hemodynamic performance of the homograft in the pulmonary position and to determine its impact on right ventricular function and clinical status.
M Briand; P Pibarot; J G Dumesnil; P Cartier
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  102     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-22     Completed Date:  2000-12-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  III10-4     Citation Subset:  IM    
Quebec Heart Institute/Laval Hospital, Laval University, Ste-Foy, Quebec, Canada.
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MeSH Terms
Aortic Valve / surgery*,  ultrasonography*
Aortic Valve Insufficiency / epidemiology,  etiology,  mortality
Body Surface Area
Echocardiography, Doppler, Color
Follow-Up Studies
Heart Valve Diseases / surgery*,  ultrasonography
Pulmonary Valve / transplantation*,  ultrasonography*
Transplantation, Autologous / adverse effects
Treatment Outcome
Vascular Patency

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

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