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The Annals of Thoracic Surgery, Vol 51, 424-429, Copyright © 1991 by The Society of Thoracic Surgeons
G Gerosa, R McKay and DN Ross
Between January 1967 and December 1988, 34 patients ranging in age from 3
to 18 years (mean, 14 +/- 3.6 years) underwent replacement of the aortic
valve or root with their own pulmonary valve. The indication for operation
was left ventricular outflow obstruction in 16 patients (47%), aortic
regurgitation in 14 (41%), mixed aortic valve disease in 3 (9%), and
failure of a previously implanted aortic homograft in 1 (3%). There were
four early deaths, all before 1971, giving a hospital mortality of 11.8%
(70% confidence interval, 6% to 20%). Surviving patients have been followed
up a cumulative total of 214 patient-years, the longest period of
observation being 16 years 8 months. Late mortality was 13.3% (70%
confidence interval, 7% to 23%), and 4 other patients required removal of
the pulmonary autograft for endocarditis. Actuarial rates at 16 years were
74% +/- 11% for freedom from reoperation on the left ventricular outflow
tract, 80% +/- 10% for freedom from reoperation on the right ventricular
outflow tract, and 77% +/- 10% for late survival. There was no instance of
primary structural degeneration in the pulmonary autograft, and all
surviving patients were in New York Heart Association functional class I
without medication. This experience demonstrates that the pulmonary
autograft can achieve good early and medium-term results in young patients.
Should growth potential be realized, it might constitute the ideal
biological valve for the left ventricular outflow in children.
ARTICLES
Replacement of the aortic valve or root with a pulmonary autograft in children
National Heart Hospital, London, England.
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T. Chotivatanapong, P. Chaiseri, C. Kasemsarn, C. Yotthasurodom, V. Sungkahapong, S. Cholitkul, T. Chotivatanapong, P. Chaiseri, C. Kasemsarn, C. Yotthasurodom, et al. Aortic Valve Reconstruction: Midterm Results from Central Chest Hospital Asian Cardiovasc Thorac Ann, September 1, 2000; 8(3): 231 - 234. [Abstract] [Full Text] [PDF]
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A. F. Merrick, M. H. Yacoub, S. Y. Ho, and R. H. Anderson Anatomy of the muscular subpulmonary infundibulum with regard to the Ross procedure Ann. Thorac. Surg., February 1, 2000; 69(2): 556 - 561. [Abstract] [Full Text] [PDF]
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C. Alexiou, A. McDonald, S. M. Langley, M. J.R. Dalrymple-Hay, M. P. Haw, and J. L. Monro Aortic valve replacement in children: are mechanical prostheses a good option? Eur. J. Cardiothorac. Surg., February 1, 2000; 17(2): 125 - 133. [Abstract] [Full Text] [PDF]
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L. Solymar, G. Sudow, and D. Holmgren INCREASE IN SIZE OF THE PULMONARY AUTOGRAFT AFTER THE ROSS OPERATION IN CHILDREN: GROWTH OR DILATION? J. Thorac. Cardiovasc. Surg., January 1, 2000; 119(1): 4 - 9. [Abstract] [Full Text] [PDF]
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W. Daenen, H. Jalali, B. Eyskens, and M. Gewillig Mid-term results of the Ross procedure Eur. J. Cardiothorac. Surg., June 1, 1999; 13(6): 673 - 677. [Abstract] [Full Text] [PDF]
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K. Niwaya, C. J. Knott-Craig, K. Santangelo, M. M. Lane, K. Chandrasekaran, and R. C. Elkins Advantage of autograft and homograft valve replacement for complex aortic valve endocarditis Ann. Thorac. Surg., June 1, 1999; 67(6): 1603 - 1608. [Abstract] [Full Text] [PDF]
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D. Mazzitelli, T. Guenther, C. Schreiber, M. Wottke, J. Michel, and H. Meisner Aortic valve replacement in children: are we on the right track? Eur. J. Cardiothorac. Surg., May 1, 1999; 13(5): 565 - 571. [Abstract] [Full Text] [PDF]
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P. T. Roughneen, S. Y. DeLeon, B. W. Eidem, N. J. Thomas, F. Cetta, D. A. Vitullo, K. E. Magliato, T. E. Berry, and M. Bakhos Semilunar valve switch procedure: autotransplantation of the native aortic valve to the pulmonary position in the ross procedure Ann. Thorac. Surg., March 1, 1999; 67(3): 745 - 750. [Abstract] [Full Text] [PDF]
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R. E. Delius, M. M. Samyn, and D. M. Behrendt Should a bicuspid aortic valve be replaced in the presence of subvalvar or supravalvar aortic stenosis? Ann. Thorac. Surg., October 1, 1998; 66(4): 1337 - 1342. [Abstract] [Full Text] [PDF]
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J.R. Bockoven, G. Wernovsky, V. L. Vetter, T. S. Wieand, T. L. Spray, and L. A. Rhodes Perioperative conduction and rhythm disturbances after the Ross procedure in young patients Ann. Thorac. Surg., October 1, 1998; 66(4): 1383 - 1388. [Abstract] [Full Text] [PDF]
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R. C. Elkins, C. J. Knott-Craig, K. E. Ward, and M. M. Lane The Ross Operation in Children: 10-Year Experience Ann. Thorac. Surg., February 1, 1998; 65(2): 496 - 502. [Abstract] [Full Text] [PDF]
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F. M. Lupinetti, J. Warner, T. K. Jones, and S. P. Herndon Comparison of Human Tissues and Mechanical Prostheses for Aortic Valve Replacement in Children Circulation, July 1, 1997; 96(1): 321 - 325. [Abstract] [Full Text]
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R. B. Hokken, A. H. Cromme-Dijkhuis, A. J. J. C. Bogers, S. E. C. Spitaels, M. Witsenburg, J. Hess, and E. Bos Clinical Outcome and Left Ventricular Function After Pulmonary Autograft Implantation in Children Ann. Thorac. Surg., June 1, 1997; 63(6): 1713 - 1717. [Abstract] [Full Text]
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R. B. Hokken, A. J. J. C. Bogers, M. A. Taams, M. B. Schiks-Berghourt, L. A. van Herwerden, J. R. T. C. Roelandt, and E. Bos DOES THE PULMONARY AUTOGRAFT IN THE AORTIC POSITION IN ADULTS INCREASE IN DIAMETER? AN ECHOCARDIOGRAPHIC STUDY J. Thorac. Cardiovasc. Surg., April 1, 1997; 113(4): 667 - 674. [Abstract] [Full Text]
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T. E. David, A. Omran, G. Webb, H. Rakowski, S. Armstrong, and Z. Sun GEOMETRIC MISMATCH OF THE AORTIC AND PULMONARY ROOTS CAUSES AORTIC INSUFFICIENCY AFTER THE ROSS PROCEDURE J. Thorac. Cardiovasc. Surg., November 1, 1996; 112(5): 1231 - 1239. [Abstract] [Full Text]
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V. A. Starnes, G. B. Luciani, W. J. Wells, R. B. Allen, and A. B. Lewis Aortic Root Replacement With the Pulmonary Autograft in Children With Complex Left Heart Obstruction Ann. Thorac. Surg., August 1, 1996; 62(2): 442 - 448. [Abstract] [Full Text]
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R. C. Elkins, M. M. Lane, and C. McCue Pulmonary Autograft Reoperation: Incidence and Management Ann. Thorac. Surg., August 1, 1996; 62(2): 450 - 455. [Abstract] [Full Text]
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J. A. M. van Son, V. M. Reddy, M. D. Black, H. Rajasinghe, G. S. Haas, and F. L. Hanley MORPHOLOGIC DETERMINANTS FAVORING SURGICAL AORTIC VALVULOPLASTY VERSUS PULMONARY AUTOGRAFT AORTIC VALVE REPLACEMENT IN CHILDREN J. Thorac. Cardiovasc. Surg., June 1, 1996; 111(6): 1149 - 1157. [Abstract] [Full Text]
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P. H. Schoof, M. G. Hazekamp, and H. A. Huysmans Pulmonary Autograft in Ventricular Septal Defect-Aortic Insufficiency Complex Ann. Thorac. Surg., March 1, 1996; 61(3): 1005 - 1006. [Abstract] [Full Text]
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M. D. Black, J. A. M. van Son, and F. L. Hanley Modified Pulmonary Autograft Aortic Root Replacement: The Sinus Obliteration Technique Ann. Thorac. Surg., November 1, 1995; 60(5): 1434 - 1436. [Abstract] [Full Text]
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N. T. Kouchoukos Reconstructive Surgery of the Aortic Root Ann. Thorac. Surg., September 1, 1995; 60(3): 734 - 735. [Full Text]
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J. W. Gaynor, C. Bull, I. D. Sullivan, B. E. Armstrong, J. E. Deanfield, J. F. N. Taylor, P. G. Rees, R. M. Ungerleider, M. R. de Leval, J. Stark, et al. Late Outcome of Survivors of Intervention for Neonatal Aortic Valve Stenosis Ann. Thorac. Surg., July 1, 1995; 60(1): 122 - 125. [Abstract] [Full Text]
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A. Giamberti, S. Giannico, C. Squitieri, F. S. Iorio, A. Amodeo, A. Carotti, S. Picardo, and C. Marcelletti Neonatal Pulmonary Autograft Implantation for Cardiac Tumor Involving Aortic Valve Ann. Thorac. Surg., May 1, 1995; 59(5): 1219 - 1221. [Abstract] [Full Text]
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 D. P. Taggart, N. T. Kouchoukos, V. G. Davila-Roman, and T. L. Spray Replacement of the Aortic Root with a Pulmonary Autograft N. Engl. J. Med., June 2, 1994; 330(22): 1615 - 1616. [Full Text]
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P. H. Schoof, A. H. Cromme-Dijkhuis, A. J. J. C. Bogers, E. J. M. Thijssen, M. Witsenburg, J. Hess, and E. Bos Aortic root replacement with pulmonary autograft in children J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 367 - 373. [Abstract] [Full Text]
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N. T. Kouchoukos, V. G. Davila-Roman, T. L. Spray, S. F. Murphy, and J. B. Perrillo Replacement of the Aortic Root with a Pulmonary Autograft in Children and Young Adults with Aortic-Valve Disease N. Engl. J. Med., January 6, 1994; 330(1): 1 - 6. [Abstract] [Full Text]
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R. C. Elkins Pulmonary Autograft -- The Optimal Substitute for the Aortic Valve? N. Engl. J. Med., January 6, 1994; 330(1): 59 - 60. [Full Text]
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