Affordable Access

Publisher Website

Aortic Valve Replacement With the Pulmonary Autograft: Mid-Term Results

The Annals of Thoracic Surgery
Publication Date
DOI: 10.1016/j.athoracsur.2005.03.023
  • Medicine


Background The purpose of this study is to assess the mid-term results of aortic valve replacement with the pulmonary autograft. Methods From October 1993 through September 2003, 153 patients with aortic valve disease (81 rheumatic and 72 non-rheumatic), with a mean age of 28 ± 14.2 years underwent the Ross procedure with root replacement technique and right ventricular outflow tract reconstruction using a homograft. Associated procedures included mitral valve repair (n = 19), open mitral commissurotomy (n = 15), tricuspid valve repair (n = 2), homograft mitral valve replacement (n = 2), and subaortic membrane resection (n = 1). Results Early mortality was 6.5% (10 patients). Mean follow-up was 77 ± 42 months (range, 7 to 132 months; median, 90 months). One hundred, twenty-one survivors (84.6%) had no significant aortic regurgitation. Reoperation was required in 10 patients for autograft dysfunction alone (n = 3), infective endocarditis (n = 2), autograft dysfunction with failed mitral valve repair (n = 3), and failed mitral valve repair alone (n = 2). No reoperations were required for the pulmonary homograft. There were 8 late deaths. Actuarial and reoperation-free survival at 90 months were 91.% ± 3.5%, 95.3% ± 2.7%, in non-rheumatics and 86.1 ± 3.9%, 90.5 ± 3.7% in rheumatics, respectively. Freedom from significant aortic stenosis or regurgitation was 91.5 ± 2.8% in non-rheumatics and 80.6 ± 4.8% in rheumatics. Event-free survival was 86.2 ± 4.9% in non-rheumatics and only 68.9 ± 5.3% in rheumatics. Conclusions The Ross procedure is not recommended for young patients (< 30 years) with rheumatic heart disease. It provides satisfactory hemodynamic and clinical results in properly selected patients. Important autograft dilatation was not observed in our patients.

There are no comments yet on this publication. Be the first to share your thoughts.


Seen <100 times

More articles like this

Aortic allograft and pulmonary autograft for aorti...

on Cardiovascular surgery (London... October 1997

Aortic valve replacement with the pulmonary autogr...

on The Annals of Thoracic Surgery August 2005

Pulmonary autograft aortic valve replacement: long...

on Journal of cardiac surgery December 1991
More articles like this..