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Midterm Results of the Ross Procedure in a Pediatric Population: Bicuspid Aortic Valve Is Not a Contraindication.

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El Behery, S Absil, Bruno Rubay, Jean [UCL] Sluysmans, Thierry [UCL] Ovaert, Caroline [UCL]

Our objective was to analyze retrospectively the short- and midterm results of the Ross operation in children and the impact of bicuspid aortic valve (BAV) disease on outcome. From 1991 to 2003, 41 patients (26 male, 15 female) underwent a Ross procedure. Aortic disease was congenital in all but one. Sixty-six percent had BAV. Mean age at operation was 10.13 +/- 5.6 years (range, 0.4-18.3 years). Root replacement technique was performed in all but two (inclusion technique). There were two early deaths. Mean follow-up was 6 +/- 3.8 years (range, 0.1-14 years). The autograft (neo-aorta) presented absent, trivial, mild, and moderate regurgitation in 42%, 46%, 10%, and 2%, respectively, at latest follow-up. Root dilation was seen in 64% of the patients (mean Z-score, +3.53 +/- 0.04). Four patients (9%) required allograft replacement, two for endocarditis and two for stenosis. Allograft stenosis (gradient >20 mmHg) was detected in 44% of the remaining patients, without symptoms or the need for reintervention. Estimated freedom from allograft replacement at 5 and 10 years was 97% and 89%. Left ventricular dimensions and function were normal in all patients. No difference was found between patients with BAV and those with tricuspid aortic valves in aortic regurgitation or root dilation. BAV was not identified as a risk factor for root dilation. In conclusion, the Ross operation remains an excellent option for aortic valve replacement in children. BAV is not associated with a worse outcome and is not a risk factor for aortic root dilation at medium-term follow-up. Long-term follow-up is, however, required.

Document type Article de périodique (Journal article) – Comparative Study, Journal Article
Access type Accès restreint
Publication date 2009
Journal information "Pediatric cardiology" - Vol. 30, no. 3, p. 219-24 (2009)
Peer reviewed yes
issn 0172-0643
Publication status Publié
Affiliations UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique
UCL - MD/CHIR - Département de chirurgie
UCL - MD/GYPE - Département de gynécologie, d'obstétrique et de pédiatrie
MESH Subject Treatment Outcome ; Transplantation, Autologous ; Time Factors ; Retrospective Studies ; Pulmonary Valve - transplantation ; Mitral Valve - abnormalities ; Male ; Infant ; Humans ; Heart Valve Prosthesis Implantation - methods ; Heart Valve Diseases - congenital - diagnosis - surgery ; Follow-Up Studies ; Female ; Echocardiography, Doppler ; Child, Preschool ; Child ; Adolescent
Links
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Bibliographic reference El Behery, S ; Absil, Bruno ; Rubay, Jean ; Sluysmans, Thierry ; Ovaert, Caroline. Midterm Results of the Ross Procedure in a Pediatric Population: Bicuspid Aortic Valve Is Not a Contraindication.. In: Pediatric cardiology, Vol. 30, no. 3, p. 219-24 (2009)
Permanent URL http://hdl.handle.net/2078.1/20862