Replacement of the aortic root with a pulmonary autograft; short term results from 8 patients

Shin, Eun Sug; Hong, Suk Keun; Hwang, Hweung Kon

Abstract

BACKGROUND: Ross procedure is the pulmonary valve autograft in the aortic valve disease, and its use trends to increase after introduced by Ross in 1967, firstly. The most important point is that it is a permanent valve replacement. It is to be ideal method to the young patient because the graft is a viable tissue to be able to grow, and hemodynamically, most similar to the normal aortic valve, and doesn't need to do anticoagulation therapy due to not having the thromboembolism, but not popular because it has a lot of technical problem and doesn't have the long-term follow-up
METHODS
The patients were 8 admitted between October 1997 and October 1998, the age from 15 to 39 ; 6 males and 2 females. The causes of disease were 4 patients of rheumatic disease, 1 of a infective endocarditis with the aortic annular abscess,1 of recurred severe aortic insufficiency 2 years after replacement. Two patients used the homograft and 6 patients switched a diseased aortic valve with the pulmonary autograft.
RESULTS
There were no death and the preoperative dyspnea nearly disappeared (NYHA FC III-IV -> I-II). The diastolic diameter of left ventricle decreased significantly when we compared to the previous echocardiography 1 month after the operation, and we observed the mild aortic valve insufficiency in 3 patients, severe in 4, mild pulmonary valve insufficiency in 4, severe in 1, and mild pulmonary valve stenosis in 4.
CONCLUSION
The operative death rate of Ross procedure in the aortic valve disease was not higher than the artificial valve replacement. Therefore, if we find the appropriate indication of operation, we can expect better results and think that we should have the long-term follow-up furthermore.