Vol.3 - No.2

The Ross Operation in Children and Young Adults: A Fifteen-Year,Single-Institution Experience

By : baghaei

Keywords : -

The optimal operation for aortic valve disease
in children and young adults remains controversial.
The Ross operation offers avoidance of anticoagulation and
the potential for growth but is technically demanding and
creates double-valve disease. The goal of this study is to
report our experience with the Ross operation and the need
for reintervention at intermediate follow-

Methods

A retrospective review of Ross operations in a
single surgeon experience from 1992 to 2007 was conducted.
All echocardiograms were reevaluated by a single
cardiologist.

Results

The cohort included 54 patients with a mean age
of 13.5 years (range 0.5 to 35 years). Pulmonary autograft
implantation was accomplished using root replacement (n
= 43), root inclusion (n = 9), and Dacron tube root replace-(n = 2). Follow-up was available for 47 patients (87%)
at a mean length of 6.4 years. There were no deaths. Kaplan-
Meier estimates of freedom from explantation at 10 years
were 100% for the autograft and 71% for the homograft.
Autograft insufficiency at latest follow-up was trivial in 37
patients (82%), mild in 6 patients (13%), and moderate in
2 patients (4%). Reintervention for the homograft included
balloon dilation in 3 children and conduit change in 5 children
(all 2 years old at initial operation).

Conclusion

The Ross operation can be performed in children
and adults with low mortality and can provide a durable
result for the aortic valve with a low incidence of aortic
insufficiency. The need for homograft replacement during
follow-up in our series was primarily limited to children
who were age 2 years or younger at initial operation.

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