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Related Experiment Video

Updated: Jul 11, 2026

A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position

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Mitral valve replacement with a pulmonary autograft: initial experience.

S S Kabbani¹, D N Ross, H Jamil

¹Damascus University Cardiovascular Surgical Center, Syria.

The Journal of Heart Valve Disease

|August 26, 1999

Summary

The pulmonary autograft offers a viable alternative for mitral valve replacement, addressing limitations of mechanical prostheses and xenografts. This technique shows excellent early function in patients with rheumatic mitral valve disease.

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Last Updated: Jul 11, 2026

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Area of Science:

Cardiovascular Surgery
Thoracic Surgery
Biomedical Engineering

Background:

Mechanical prostheses require lifelong anticoagulation, posing challenges in developing countries.
Xenografts have limited durability in younger populations, and homografts are not yet established.
Previous research in 1967 explored autograft concepts for valve replacement.

Purpose of the Study:

To evaluate the feasibility and efficacy of using a pulmonary autograft for mitral valve replacement.
To address the limitations of existing prosthetic and homograft options for mitral valve substitution.

Main Methods:

The Ross procedure was adapted to use an inverted pulmonary autograft within a Dacron conduit for mitral valve replacement.
The autograft-conduit was sutured to the mitral annulus, with the proximal end attached to the atrial wall.
Right ventricular outflow reconstruction was performed using homografts or xenografts.

Main Results:

One patient experienced a fatal cerebrovascular accident, likely due to a misplaced pericardial collar.
Another patient required autograft replacement due to early bacterial endocarditis.
Echocardiography demonstrated excellent function of the remaining autografts up to 16 months postoperatively.

Conclusions:

The pulmonary autograft is presented as a potentially valid option for mitral valve replacement.
This technique may offer a suitable alternative in specific patient populations and healthcare settings.