| Results of the Ross operation in a pediatric population. | |
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MedLine Citation:
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PMID: 15896604 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To analyse the results of the mid-term clinical and echocardiographic follow-up of the pediatric Ross operation. METHODS: Echo-Doppler follow-up of 53 consecutive pediatric Ross procedures performed between 1994 and 2003. Median age was 9.7 years at time of operation (2 weeks-17.7 years). Six patients were younger than 3 months. Median age at follow-up was 15.6 years. Aortic valve/left ventricular outflow tract (LVOT) anomalies were congenital in 49 (92%). Seventy percent had previous surgery or balloon valvuloplasty. Root replacement was used in all. Thirteen patients (25%) had LVOT enlargement. Mean cross-clamp time was 113 (69-189) minutes. RESULTS: Early mortality occurred in 3 patients after emergency surgery following balloon failure (n=1) and extended Ross following interrupted arch/VSD repair (n=2). Late mortality was due to LV fibroelastosis in 2 patients and complicated pulmonary artery stenting in another. RVOT reoperations were required because of late homograft obstruction in 2 patients and because of pulmonary artery stenosis in another. Five patients (9.4%) were reoperated for pulmonary autograft dilatation (n=3) and for leaflet fibrosis or perforation (n=2). Autografts were repaired in two patients, while a mechanical valve was inserted in 3 cases. At 9 years the actuarial survival and event free survival were 89 and 74%, respectively. At last follow-up 90% of autograft diameters indexed to body surface area was above the 90th percentile of normal aortic root diameters. LVOT and RVOT gradients were low and autograft insufficiency was trivial to mild in 84% and mild to moderate in 16%. Autograft stenosis was not noticed. CONCLUSIONS: The pediatric Ross procedure remains an important tool but autograft dilatation also occurs in the pediatric population. The significance of this finding has yet to be determined. |
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Authors:
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Mark G Hazekamp; Heynric B Grotenhuis; Paul H Schoof; Marie E B Rijlaarsdam; Jaap Ottenkamp; Robert A E Dion |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 27 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2005 Jun |
Date Detail:
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Created Date: 2005-05-17 Completed Date: 2005-10-11 Revised Date: 2006-03-02 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 975-9 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic Surgery D6-26, Leiden University Medical Center, 2300 RC Leiden, The Netherlands. m.g.hazekamp@lumc.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Aortic Valve / surgery* Aortic Valve Insufficiency / mortality, surgery*, ultrasonography Aortic Valve Stenosis / mortality, surgery*, ultrasonography Child Child, Preschool Disease-Free Survival Echocardiography, Doppler Follow-Up Studies Heart Valve Prosthesis Implantation* Humans Infant Infant, Newborn Pulmonary Valve Survival Rate Transplantation, Autologous Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Eur J Cardiothorac Surg. 2005 Oct;28(4):663; author reply 663-4
[PMID:
16126402
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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