Recycling of the Pulmonary Autograft During Reverse Ross Operation: From Pulmonary Valve to Neoaortic Valve and Back

2019 ◽  
Vol 10 (2) ◽  
pp. 242-244
Author(s):  
Martin Schmiady ◽  
Dominique Bettex ◽  
Michael Hübler ◽  
Martin Schweiger
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Operative Technique ◽  
Pulmonary Valve ◽  
Ross Procedure ◽  
Ross Operation ◽  
Pulmonary Autograft ◽  
Hemodynamic Profile ◽  
Children And Young Adults

The Ross operation is the operation of choice for children and young adults who require aortic valve replacement. Although the allograft does not require anticoagulation and has a superior hemodynamic profile compared to other valve substitutes, concerns regarding allograft and autograft longevity have risen in the last decade. We present a case illustrating an alternative operative technique for patients with failed Ross procedure in which the autograft is recycled in order to avoid a two-allograft replacement.

scholarly journals Aortic Valve Replacement and the Ross Operation in Children and Young Adults

2016 ◽  
Vol 67 (24) ◽  
pp. 2858-2870 ◽  
Author(s):  
Mansour T.A. Sharabiani ◽  
Dan M. Dorobantu ◽  
Alireza S. Mahani ◽  
Mark Turner ◽  
Andrew J. Peter Tometzki ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Ross Operation ◽  
Children And Young Adults

Bovine jugular vein conduit versus pulmonary homograft in the Ross operation

2019 ◽  
Vol 30 (3) ◽  
pp. 323-327
Author(s):  
Parth M. Patel ◽  
Jeremy L. Herrmann ◽  
Mark D. Rodefeld ◽  
Mark W. Turrentine ◽  
John W. Brown
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Jugular Vein ◽  
Interquartile Range ◽  
Ross Procedure ◽  
Ross Operation ◽  
Bovine Jugular Vein ◽  
Pulmonary Homograft

AbstractObjectives:The Ross procedure involves using the native pulmonary valve for aortic valve replacement then replacing the pulmonary valve with an allograft or xenograft. We aimed to compare our age-matched experience with the bovine jugular vein conduit and the pulmonary homograft for pulmonary valve replacement during the Ross procedure in children.Methods:Between 1998 and 2016, 15 patients <18 years of age underwent a Ross procedure using the bovine jugular vein conduit (Ross-Bovine Jugular Vein Conduit) at our institution. These patients were age-matched with 15 patients who had the Ross operation with a standard pulmonary homograft for right ventricular outflow tract reconstruction (Ross-Pulmonary Homograft). Paper and electronic medical records were retrospectively reviewed.Results:The median age of the Ross-Bovine Jugular Vein Conduit and Ross-Pulmonary Homograft patients were 4.8 years (interquartile range 1.1–6.6) and 3.3 years (interquartile 1.2–7.6), respectively (p = 0.6). The median follow-up time for the Ross-Bovine Jugular Vein Conduit and Ross-Pulmonary Homograft groups were 1.7 years (interquartile range 0.5–4.9) and 6.8 years (interquartile range 1.9–13.4), respectively (p = 0.03). Overall, 5-year survival, freedom from redo aortic valve replacement, and freedom from pulmonary valve replacement were similar between groups.Conclusion:The bovine jugular vein conduit and pulmonary homograft have favourable mid-term durability when used for right ventricular outflow tract reconstruction for the Ross operation. The bovine jugular vein conduit may be a suitable replacement for appropriately sized patients undergoing a Ross aortic valve replacement, though longer follow-up is needed.

Ross Procedure: How to Do It and How to Teach It

2019 ◽  
Vol 10 (5) ◽  
pp. 624-627
Author(s):  
Jeremy L. Herrmann ◽  
Amanda R. Stram ◽  
John W. Brown
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Pulmonary Valve ◽  
Prosthetic Graft ◽  
Ascending Aorta ◽  
Ross Procedure

Prosthesis choice for aortic valve replacement (AVR) in children is frequently compromised by unavailability of prostheses in very small sizes, the lack of prosthetic valve growth, and risks associated with long-term anticoagulation. The Ross procedure with pulmonary valve autograft offers several advantages for pediatric and adult patients. We describe our current Ross AVR technique including replacement of the ascending aorta with a prosthetic graft. The procedure shown in the video involves an adult-sized male with a bicuspid aortic valve, mixed aortic stenosis and insufficiency, and a dilated ascending aorta.

scholarly journals Subcoronary Ross/Ross–Konno operation in children and young adults: initial single-centre experience

2020 ◽  
Vol 59 (1) ◽  
pp. 226-233 ◽  
Author(s):  
Peter Murin ◽  
Viktoria H.M Weixler ◽  
Jasmin Moulla-Zeghouane ◽  
Olga Romanchenko ◽  
Anastasia Schleiger ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Root ◽  
Somatic Growth ◽  
Left Ventricular ◽  
Mortality And Morbidity ◽  
Excellent Outcome ◽  
Ross Operation ◽  
Children And Young Adults ◽  
Konno Operation

Abstract OBJECTIVES We sought to evaluate the outcome after modified subcoronary Ross/Ross–Konno operation in children and young adults. METHODS Between January 2013 and January 2019, a total of 50 patients with median age of 6.3 years (range 0.02–36.5 years, 58% males), including 10 infants (20%), received modified subcoronary Ross/Ross–Konno operation at our institution. Survival, morbidity, reinterventions, aortic valve function and aortic root dimensions were analysed. RESULTS At a median follow-up of 31.2 months (range 14.4–51 months), there were 1 early death and 1 late death, both in the infant group. The overall survival at 5 years after the operation was 95%. Two patients needed aortic valve replacement, 11 and 15 months after their Ross operation. At 5 years, freedoms from reoperation on the autograft and on the right ventricle to pulmonary artery conduit were 94% and 97%, respectively. Freedom from aortic valve regurgitation greater than mild was 97% at 5 years. Median dimensions of the aortic root at all levels remained in normal range at last visit. Forty-four patients (95%) were in New York Heart Association class I with normal left ventricular function. CONCLUSIONS The initial experience with the subcoronary Ross/Ross–Konno operation in children and young adults showed excellent outcome. The mortality and morbidity among infants remain significant. The described technique is reproducible and might be advantageous in situations when prosthetic supporting techniques interfere with somatic growth.

Outcome after mechanical aortic valve replacement in children and young adults

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
R Arnold ◽  
T Loukanov ◽  
C Sebening ◽  
J Ley-Zaporozhan ◽  
S Ley ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mechanical Aortic Valve ◽  
Children And Young Adults
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