The role of Ross procedure in the management of congenital heart defects

2013 ◽  
Vol 154 (6) ◽  
pp. 219-224
Author(s):  
István Hartyánszky ◽  
András Kollár ◽  
Krisztina Kádár ◽  
László Ablonczy ◽  
Edit Novák ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Left Ventricular Outflow Tract ◽  
Heart Defects ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Left Ventricular Outflow

Introduction: The surgical strategy to manage multilevel left ventricular outflow tract diseases is changing constantly, however, the Ross-procedure has remained a standard method for 45 years. Aim: The aim of the study was to analyze early and mid-term results of Ross-procedure in congenital heart defects (single surgeon’s results). Methods: From 2001 until 2011 a total of 63 patients (age, 28 days–21 years; mean: 10 years, weight 3.4–96 kg; mean, 8.8 kg) underwent Ross (n = 40), Ross–Konno (n = 17) or Ross–Konno-mitral (n = 6) procedures. Indication for Ross procedure was aortic regurgitation in 15 patients (associated with ventricular septum defect in 8 patients) and a predominant aortic stenosis in 25 patients. 17 patients with severe left ventricular outflow tract obstruction underwent Ross–Konno procedure. 6 patients with concomitant mitral valve disease (Shone syndrome, 3 patients; complete atrioventricular septal defect, 3 patients) were reconstructed by Ross–Konno-mitral valve procedure. Results: Among Ross patients there were one early (cerebral complication) and one late death (homograft endocarditis) with a mean follow-up time of 7.4±1.8 years. Because of an early autograft endocarditis a 3-year-old boy underwent homograft implantation and was treated successfully with Bentall-procedure 9 years later. One patient with autograft regurgitation is waiting for reoperation. Among Ross–Konno patients there was no early or late death, and none of the patients underwent reoperation. In Ross–Konno-mitral patients there was one early death (28-day-old boy) and during a mean follow-up time of 2.5±1 years, and no reintervention or reoperation was needed in 5 patients. Conclusions: The results indicate a good outcome of Ross-, Ross–Konno-, Ross–Konno-mitral procedures in patients with congenital heart defects when surgery is performed by a highly experienced heart surgeon. In newborns, infants and small children Ross- and Ross–Konno procedures are the only methods for managing left ventricular outflow tract diseases. Concomitant severe mitral disease adds a high level of technical complexity to the Ross–Konno/mitral procedure, but it should be balanced against alternative strategies (eg. single ventricle palliation or transplantation). Orv. Hetil., 2013, 154, 219–224.

Pulmonary Autograft Coronary-Cameral Fistula Leading to LVOT Pseudoaneurysm Post Ross Procedure

2020 ◽  
pp. 215013512093899
Author(s):  
Habib Jabagi ◽  
Letizia Gardin ◽  
Gyaandeo Maharajh
Keyword(s):  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Pulmonary Autograft ◽  
Left Ventricular Outflow ◽  
Coronary Cameral Fistula ◽  
Coronary Cusp

We report the case of a presumed coronary-cameral fistula arising directly below the commissures of the noncoronary cusp (NCC) and left coronary cusp (LCC) of the pulmonary autograft, leading to left ventricular outflow tract pseudoaneurysm and late tamponade post Ross procedure.

Mortality and complications in 3495 children with isolated ventricular septal defects

2016 ◽  
Vol 101 (9) ◽  
pp. 808-813 ◽  
Author(s):  
Jarle Jortveit ◽  
Elisabeth Leirgul ◽  
Leif Eskedal ◽  
Gottfried Greve ◽  
Tatiana Fomina ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Aortic Regurgitation ◽  
Left Ventricular Outflow Tract ◽  
Heart Defects ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Cardiac Complications ◽  
Septal Defects ◽  
Left Ventricular Outflow

BackgroundVentricular septal defects (VSDs) are the most common congenital heart defects (CHDs). Previous studies indicate an increased risk of endocarditis, aortic regurgitation, left ventricular outflow tract obstructions, pulmonary hypertension, arrhythmias and sudden death in patients with isolated VSDs. The present nationwide cohort study reports mortality and cardiac complications requiring hospitalisation or intervention in children with isolated VSDs.Methods and resultsMedical information concerning all 943 871 live births in Norway in 1994–2009 was retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry of Congenital Heart Defects and the Norwegian Cause of Death Registry. Isolated VSDs were identified in 3495 children without known chromosomal aberrations or extracardiac malformations. Surgical or catheter-based treatment of VSD was performed in 181 (5.2%) cases. Twelve (0.3%) children with VSDs died before 2013. There was no operative mortality, and no excess mortality in children with isolated VSDs compared with children without VSDs (adjusted HR 0.8 (0.5 to 1.4), p=0.48). The following conditions were recorded as possible cardiac complications of the VSDs: endocarditis in 3 children (0.9‰), aortic regurgitation in 12 children (3.4‰), left ventricular outflow tract obstructions in no children (0.0‰), pulmonary hypertension in 1 child (0.3‰) and arrhythmias in 16 children (4.6‰).ConclusionsThe entire group of children with isolated VSDs had a favourable prognosis without excess mortality. Cardiac complications requiring hospitalisation or intervention, including endocarditis, aortic regurgitation, left ventricular outflow tract obstructions, pulmonary hypertension and arrhythmias, were infrequent during childhood.Trial registration numberNCT02026557.

The Nikaidoh procedure for complex transposition of the great arteries: short-term follow-up

2016 ◽  
Vol 27 (5) ◽  
pp. 945-950
Author(s):  
Guillermo Ventosa-Fernández ◽  
Carolina Pérez-Negueruela ◽  
Javier Mayol ◽  
Marina Paradela ◽  
José M. Caffarena-Calvar
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Complex Forms

AbstractBackgroundThe surgical treatment for complex forms ofd-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction remains controversial. In this study, we describe the classical surgical options – namely, the Rastelli procedure and the “réparation à l’étage ventriculaire” – and present our experience with the modified Nikaidoh procedure with early and short-term follow-up results.MethodsBetween 2007 and 2014, four patients withd-transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract obstruction underwent surgical repair at our institution by means of a modified Nikaidoh procedure.ResultsWith a mean follow-up of 4.5 years, survival was 100%, and none of the patients required re-intervention or mechanical circulatory support. There was no recurrence of left ventricular outflow tract obstruction and no aortic valve regurgitation classified as more than mild. Left ventricular function was preserved.ConclusionsAortic translocation with the modified Nikaidoh procedure is a safe and effective surgical treatment for certain complex forms of transposition of the great arteries, particularly those associated with ventricular septal defect and left ventricular outflow tract obstruction. It is associated with less need for re-intervention and better morbidity and mortality results in the short- and mid-term follow-up, when compared with the classical alternatives such as the Rastelli procedure.

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