A modification of the Ross procedure to prevent pulmonary autograft dilatation

Abstract

We present our initial experience in 10 patients operated on using a modified Ross operation. In our modification of the Ross operation the pulmonary autograft root was inserted in the Gelweave Valsalva graft to prevent dilatation of the neoaortic root. This type of graft was selected to match the discrepancy between diameters of the annulus and the sinotubular junction of the autograft and to preserve the characteristic configuration of the native root. In our group of 10 patients operated consecutively by this technique there was no change in the geometry of the neoaortic root in the follow-up 3-19 months (mean 14.6 months).

The Externally Supported Ross Operation: Early Outcomes and Intermediate Follow-Up

“…Our results are similar to other early and intermediate study reports for a supported Ross technique, demonstrating a low rate of neoaortic valve incompetence [8], limited to no change in the geometry of the neoaortic root [3,[9][10][11], and a low reintervention rate. In most previous reports, the externally supported Ross technique was performed using a Dacron conduit graft.…”

An experimental model of the Ross operation: Development of resorbable reinforcements for pulmonary autografts

“…Designed to address the problem of autograft root dilatation, various methods of pulmonary artery trunk reinforcement with a prosthesis have produced encouraging results. [23][24][25] However, these data came from single centers or single-surgeon, individual experience. Complete sets of experimental activities are needed to help enable a full evaluation of the morphologic, pathologic, and hemodynamic aspects of the proposed reinforcement strategy, and more importantly, a progressive follow-up of the vascular changes during growth.…”

Risk factors for pulmonary autograft dysfunction after Ross procedure

“…Наиболее часто используют наружную фиксацию ФК и синотубулярного гребня полосками из тефлона либо перикарда. В литературе [15,16,21,33] предложены методики стабилизации неокорня путем помещения легочного аутографта в сосудистый протез, которые, по мнению авторов, также позволяют предотвратить дилатацию на уровне синусов. Кроме этого, предложены оригинальные методики укрепления аутографта тканями собственного корня аорты [6,29].…”

“…External FR and sino-tubular junction fixation with teflon or pericardial strips are the most often used. The literature suggested stabilization technique of neo-root by placing pulmonary autograft into vascular prosthesis [15,16,21,33], what also can prevent sinuses dilation according to the authors. Besides, original methods for autograft reinforcement with own aortic root tissues are proposed [6,29].…”