Echocardiographic follow-up after Ross procedure in 100 patients
| Autor: | Christian Rey, Luc Goullard, Ghislaine Deklunder, Edouard Hubert, Christine Savoye, Charles Francart, Alain Prat, Jean-Luc Auffray, François Godart |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Aortic valve disease
Adult Male medicine.medical_specialty Adolescent medicine.medical_treatment Aortic Valve Insufficiency Transplantation Autologous Aortic valve replacement medicine.artery medicine Humans Transplantation Homologous Hospital Mortality Child Retrospective Studies Heart Valve Prosthesis Implantation Postoperative Care Aorta business.industry Ross procedure Reproducibility of Results Perioperative Middle Aged medicine.disease Normal limit Surgery Survival Rate medicine.anatomical_structure Echocardiography Pulmonary valve Aortic Valve Child Preschool Female Implant Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The American journal of cardiology. 85(7) |
| ISSN: | 0002-9149 |
| Popis: | The Ross procedure could provide an ideal aortic valve replacement method in children and young adults. We evaluated midterm echocardiographic results to assess pulmonary homograft function as well as pulmonary autograft dimensions and function. In all, 105 patients (26 women and 79 men) underwent the Ross procedure; median age at implant was 29 years. All patients underwent free root replacement. Transvalvular gradients and autograft dimensions were measured at 3 levels (annulus, sinuses of Valsalva, and proximal aorta) at discharge, at 6 months, and annually thereafter. Perioperative mortality was 4.7%. The mean period for echocardiographic follow-up in 100 patients was 32.7 months (range 0.5 to 7 years), during which 4 noncardiac-related deaths occurred. Two patients underwent late reintervention. No moderate or severe regurgitation was recorded. There was 1 case of mild homograft regurgitation and 4 of mild autograft regurgitation at late follow-up. Autograft peak gradients were low and reproducible (5 ± 2.8 mm Hg at discharge vs 5.5 ± 3.5 mm Hg at last follow-up, p=NS). Homograft peak gradients increased significantly without severe obstruction (7.8 ± 5.7 mm Hg at discharge vs 15.8 ± 9.2 mm Hg at last follow-up). The diameter of the autograft annulus was stable during follow-up, whereas autograft dimensions at sinuses and proximal aorta increased significantly. One group of patients was identified with sinus diameter increases >20% (group A). The 90 remaining patients were classified into group B. The only parameter significantly different between the 2 groups was the sinus diameters measured at discharge (1.74 cm/m 2 (group A) vs 1.92 cm/m 2 (group B); p=0.036). In 100 patients and with echocardiographic follow-up for up to 7 years, the Ross procedure showed excellent results. For 10% of patients, we observed a 20% dilation of sinus diameters, but in only 3 patients (3%) was this beyond the upper normal limit. |
| Databáze: | OpenAIRE |
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