Abstract
Between 1 February 1992 and 1 March 1993, we performed Ross's aortic replacement in 7 men and 4 women with rheumatic heart disease. The patients' ages ranged from 22 to 60 years (mean, 41 years). All 11 patients had aortic valve disease; 2 also had mitral valve disease. In all patients, the right ventricular outflow tract was reconstructed using an autologous pericardial conduit containing a bovine cardiac valve bioprosthesis manufactured at our institution. The 2 patients who had mitral valve disease underwent a concomitant mitral valvuloplasty. In 1 patient, minimal aortic regurgitation was documented by means of transesophageal echocardiography immediately after the cessation of cardiopulmonary bypass, but no hemodynamic compromise was noted. In another patient, mediastinal exploration was required for bleeding, 3.5 hours postoperatively. The follow-up period ranged from 6 to 16 months (mean, 11.3 months). Results were assessed by means of clinical and transesophageal echocardiographic studies. No infection or technical failure was encountered. No patient died. All patients remain asymptomatic, and follow-up echocardiography has revealed no transaortic or transpulmonary gradient. The Ross operation was chosen for this group of patients because it avoids the use of mechanical valves and subsequent anticoagulant therapy. Most of our patients have a low income and a history of noncompliance with the strict postoperative drug regimen. Although the short-term results have been excellent with the Ross operation and our combination bioprosthesis, long-term evaluation is needed.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Gonzalez-Lavin L., Gonzalez-Lavin J., Chi S., Lewis B., Amini S., Graf D. The pericardial valve in the aortic position ten years later. J Thorac Cardiovasc Surg. 1991 Jan;101(1):75–80. [PubMed] [Google Scholar]
- Gula G., Wain W. H., Ross D. N. Ten years' experience with pulmonary autograft replacements for aortic valve disease. Ann Thorac Surg. 1979 Oct;28(4):392–396. doi: 10.1016/s0003-4975(10)63140-2. [DOI] [PubMed] [Google Scholar]
- López Soriano F., Attié F., Buendía A., García Cornejo M., Zamora C. Tratamiento quirúrgico de la agenesia de la válvula pulmonar. Arch Inst Cardiol Mex. 1981 Sep-Oct;51(5):481–488. [PubMed] [Google Scholar]
- Masters R. G., Pipe A. L., Bedard J. P., Brais M. P., Goldstein W. G., Koshal A., Keon W. J. Long-term clinical results with the Ionescu-Shiley pericardial xenograft. J Thorac Cardiovasc Surg. 1991 Jan;101(1):81–89. [PubMed] [Google Scholar]
- Matsuki O., Okita Y., Almeida R. S., McGoldrick J. P., Hooper T. L., Robles A., Ross D. N. Two decades' experience with aortic valve replacement with pulmonary autograft. J Thorac Cardiovasc Surg. 1988 Apr;95(4):705–711. [PubMed] [Google Scholar]
- Ross D. N. Replacement of aortic and mitral valves with a pulmonary autograft. Lancet. 1967 Nov 4;2(7523):956–958. doi: 10.1016/s0140-6736(67)90794-5. [DOI] [PubMed] [Google Scholar]
- Ross D., Jackson M., Davies J. The pulmonary autograft--a permanent aortic valve. Eur J Cardiothorac Surg. 1992;6(3):113–117. doi: 10.1016/1010-7940(92)90115-e. [DOI] [PubMed] [Google Scholar]
- Walley V. M., Bédard P., Brais M., Keon W. J. Valve failure caused by cusp tears in low-profile Ionescu-Shiley bovine pericardial bioprosthetic valves. J Thorac Cardiovasc Surg. 1987 Apr;93(4):583–586. [PubMed] [Google Scholar]