Document Detail

Ross operation for bicuspid aortic valve disease in adults: is it a valid surgical option?
MedLine Citation:
PMID:  12018767     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The validity of the Ross operation as freestanding root replacement in adult patients with bicuspid aortic valve disease has lately been questioned. We have analyzed retrospectively our results in 23 adult patients (19 males) operated for bicuspid aortic valve disease ad modum "Ross" employing a freestanding root replacement technique. DESIGN: In 9 patients the dominant aortic valve lesion was stenotic (aortic stenosis group) and in the remaining 14 patients it was aortic insufficiency (aortic insufficiency group). The fate of the pulmonary autograft in the two groups was studied. The intraoperatively measured aortic and pulmonary annuli diameters from the two groups were compared with those from a population of normal looking aortic and pulmonary valves matched for body surface area. RESULTS: The aortic insufficiency group needed significant reduction of the aortic annulus diameter to conform to the size of the pulmonary autograft. The pulmonary autograft annuli in this group were significantly larger in diameter than the ones in the aortic stenosis group. The mean pulmonary annulus diameter in the aortic stenosis group was, on the other hand, significantly smaller when compared with that in the normal matched population. After a mean follow-up period of about 19 months, the aortic insufficiency group showed significant dilatation of the neo-aortic sinuses. Between the two groups, the remaining echocardiographic variables remained either stable or improved at follow-up. CONCLUSION: Pre-existing larger diameters of the aortic and pulmonary annuli in the aortic insufficiency group combined with the significantly increased left ventricular end-diastolic diameters, may predispose these patients to significant dilatation of the unsupported aortic sinuses after a Ross operation. This dilatation does not, however, lead to increase in the autograft valve insufficiency at short-term follow-up if the aortic annulus and the distal ascending aorta are tailored to the size of the pulmonary autograft. Ross operation, employing freestanding aortic root replacement technique, may therefore be recommended in adult patients with bicuspid aortic valve disease with excellent short-term results.
Bansi Koul; Carl-Johan Lindholm; Misha Koul; Anders Roijer
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  36     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-05-20     Completed Date:  2002-11-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  48-52     Citation Subset:  IM    
Speciality of Cardiothoracic Surgery, Heart and Lung Division, University Hospital, Lund, Sweden.
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MeSH Terms
Aortic Valve Insufficiency / mortality,  surgery
Aortic Valve Stenosis / mortality,  surgery
Cardiac Surgical Procedures / methods
Follow-Up Studies
Heart Valve Diseases / diagnosis,  mortality,  surgery*
Middle Aged
Pulmonary Valve / transplantation*
Retrospective Studies
Risk Assessment
Statistics, Nonparametric
Survival Rate
Transplantation, Autologous
Treatment Outcome
Comment In:
Scand Cardiovasc J. 2002 Sep;36(5):272-4   [PMID:  12470392 ]
Scand Cardiovasc J. 2002 Sep;36(5):275   [PMID:  12470393 ]

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