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Normalization of left ventricular dimensions after Ross operation with aortic annular reduction
K Niwaya1, R C Elkins, C J Knott-Craig
1Section of Thoracic and Cardiovascular Surgery, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
The Annals of Thoracic Surgery
|October 6, 1999
Summary
This modified Ross operation effectively treats dysplastic aortic roots, reducing left ventricular size and improving autograft valve function. The procedure offers excellent outcomes for patients needing aortic valve replacement.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Surgery
- Aortic Valve Repair
Background:
- Dysplastic dilated aortic root is a contraindication for the standard Ross operation.
- An extended Ross operation with aortic annulus reduction and external cuff fixation was performed in 57 patients.
- Patient ages ranged from 14 to 54 years, with follow-up data assessed via echocardiography.
Purpose of the Study:
- To evaluate the efficacy of an extended Ross operation in patients with a dysplastic aortic root.
- To assess autograft valve function and left ventricular remodeling post-procedure.
Main Methods:
- Echocardiographic assessment of 27 patients with aortic insufficiency (AI group) and 30 with aortic stenosis and AI (AS group).
- Comparison of preoperative and postoperative data including aortic annulus size, valvular gradient, and left ventricular dimensions.
- Measurements included end-systolic and end-diastolic dimensions, fractional shortening, and left ventricular mass.
Main Results:
- Significant reduction in aortic annulus size, AI degree, left ventricular dimensions, and mass in both AI and AS groups (p<0.05).
- Mean peak pressure gradients showed minimal change in the AI group.
- Left ventricular fractional shortening remained within normal limits pre- and postoperatively for both groups.
Conclusions:
- The modified Ross operation leads to regression of left ventricular dilatation and hypertrophy.
- Excellent autograft valve function and survival rates were observed.
- This surgical modification is a viable option for patients with dysplastic aortic roots requiring aortic valve replacement.