Abstract
Background Neo-aortic root dilatation accounts for the majority of reoperations needed after
the Ross procedure with implantation of the pulmonary autograft as complete root replacement.
This study evaluates early results of external prosthetic reinforcement of the autograft.
Methods From July 2015 to October 2017, 16 adolescent and adult patients received a Ross
procedure at our department by this technique. A congenital-dysplastic valve was present
in 13 patients, including 9 patients with a bicuspid aortic valve. Clinical and echocardiographic
follow-up is complete with a mean duration of 19.7 ± 5.8 months.
Results The mean age at operation was 27.1 ± 16.1 years. Mean aortic cross-clamping time
was 102 ± 39 minutes. No bleeding complication occurred. The median stay on the intensive
care unit was 2 days. In-hospital mortality was 0%. All patients were discharged with
no or trivial aortic regurgitation. In one patient both the autograft and homograft
were replaced because of endocarditis 3 months after the primary operation, leading
to 93.8% freedom from reoperation at 2 years. There were no late deaths during the
study period. The latest echocardiography confirmed absence of aortic regurgitation
grade >I in all patients. Neo-aortic root diameters remained stable during follow-up.
Conclusion The presented modification of the Ross procedure does not prolong ischemia time,
and can be performed with a low operative morbidity and mortality and an excellent
early valve function.
Keywords
Ross - pulmonary autograft - AG dilatation
