Preliminary results following reinforcement of the pulmonary autograft to prevent dilatation after the Ross procedure
| Autor: | Thierry Aymard, Friedrich S. Eckstein, Thierry Carrel, Markus Schwerzmann, Alexander Kadner |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine Aortic valve medicine.medical_specialty Adolescent medicine.medical_treatment Aortic Valve Insufficiency Regurgitation (circulation) Transplantation Autologous Prosthesis Bicuspid aortic valve Internal medicine medicine Humans Cardiac Surgical Procedures Pulmonary Valve business.industry Ross procedure Aortic Valve Stenosis medicine.disease Surgery Stenosis medicine.anatomical_structure Aortic Valve Pulmonary valve Circulatory system Cardiology cardiovascular system Cardiology and Cardiovascular Medicine business Dilatation Pathologic |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. (2):472-475 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2008.02.004 |
| Popis: | Objective The Ross operation remains a controversially discussed procedure, because concern exists regarding late dilatation of the neoartic root and progressive regurgitation of the autograft valve. We present our early experience with an external reinforcement of the autograft, which is inserted into a prosthetic Dacron graft with an artificial aortic root configuration. This detail should help to prevent neoaortic root dilatation. Patients and Methods Between 2006 and 2007, 12 patients (mean age 16 ± 38 years; range 15–38 years) underwent a Ross procedure by this technique. Indications were aortic regurgitation (n = 2), aortic stenosis (n = 5), and combined aortic stenosis and insufficiency (n = 5). A bicuspid aortic valve was present in 9 patients. Balloon valvuloplasty had been performed in 7 patients. Follow-up was performed by clinical and echocardiographic examinations. Results No early or late deaths occurred in this small series, and freedom from reoperation is 100%. Echocardiographic follow-up confirmed absence of aortic insufficiency in 11 patients after a mean of 11 months (range 2–30 months). In 1 patient, a small asymmetric regurgitation jet was already observed at discharge echocardiography. As expected, no neoaortic root dilatation was observed during follow-up. All patients are in New York Heart Association class I. Conclusions The present technique is a simple and reproducible technical step that does not require significant additional time. Inclusion of the autograft within a root prosthesis may be especially indicated in situations known for late autograft dilatation, namely, bicuspid aortic valve, predominant aortic insufficiency, and ascending aortic enlargement. |
| Databáze: | OpenAIRE |
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