Document Detail


Ross and Ross-Konno procedures in infants, children and adolescents: a 13-year experience.
MedLine Citation:
PMID:  19301557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Due to hemodynamic performance and potential for growth of the pulmonary autograft, the Ross operation is considered to be the surgery of choice for irreparable aortic valve disease in pediatric patients. The study aim was to analyze the long-term clinical and echocardiographic results of the Ross operation. METHODS: Between February 1993 and July 2006, 55 consecutive patients (mean age 10.0 +/- 6.2 years; range: 3 months to 18 years) underwent eithera Ross operation (n=46) or a Ross-Konno procedure (n=9). The underlying left ventricular outflow tract pathology was mainly congenital (n=47). Among patients, 23 (42%) had undergone a previous aortic valve procedure. Concomitant procedures were performed in 16 patients (29%). The Ross operation was performed as a root replacement in all cases; the mean cross-clamp time was 132 min (range: 100-188 min). The autograft diameter was indexed to the body surface area and compared to normal values. The mean follow up was 5.5 +/- 3.8 years, and was 100% complete. RESULTS: There was one early death (2%) and two late deaths (4%). The actuarial patient survival was 93% at 10 years. None of the patients developed moderate or severe autograft regurgitation. All measured maximal root diameters were above the 90th percentile of normal aortic diameter, without correlation to autograft regurgitation. Five patients (9%) had a mean homograft gradient > or = 40 mmHg, and two (4%) were reoperated on. The freedom from reoperation for homograft degeneration was 91% at 10 years. CONCLUSION: Autograft regurgitation after the Ross and Ross-Konno procedures is uncommon, and the risk of homograft degeneration appears low. Autograft dilatation is common but does not correlate with autograft regurgitation. When considering long-term freedom from autograft and homograft degeneration, the results of the present study confirm the Ross operation as the surgery of choice for irreparable aortic valve disease in infants, children and young adults.
Authors:
Alessandro Piccardo; Olivier Ghez; Vlad Gariboldi; Alberto Riberi; Frederic Collart; Bernard Kreitmann; Dominique Metras
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  18     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-03-23     Completed Date:  2009-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  76-82; discussion 83     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, La Timone Children's Hospital, Marseille, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aortic Valve / surgery*
Aortic Valve Insufficiency / congenital,  surgery*
Aortic Valve Stenosis / congenital,  surgery*
Cardiac Surgical Procedures / adverse effects,  mortality
Child
Child, Preschool
Female
Humans
Infant
Male
Postoperative Complications
Pulmonary Valve / transplantation*
Reoperation
Transplantation, Autologous
Ventricular Outflow Obstruction / congenital,  surgery*

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


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