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Ross procedure for complex left ventricular outflow tract obstruction
W R Wilson1, G E Greer, D S Durzinsky
1Department of Child Health, University of Missouri Health Sciences Center, Columbia 65212, USA.
Insights
The Ross procedure with pulmonary autografts effectively treats complex left ventricular outflow tract obstruction in children. This surgical approach offers excellent short-term valve function and avoids anticoagulation, promoting future growth.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Aortic Valve Repair
Background:
- Complex left ventricular outflow tract (LVOT) obstruction presents a significant surgical challenge in pediatric patients.
- The Ross procedure, combined with subaortic stenosis resection or Konno septal incision, is a key surgical option.
Observation:
- Two pediatric patients (14 and 5 years old) with combined subaortic and valvar stenosis underwent surgical correction using the pulmonary autograft.
- One patient had subaortic membrane resection with a pulmonary autograft; the other had a Ross Konno procedure.
Findings:
- Both patients experienced uncomplicated postoperative hospital stays and were discharged within 5 days.
- At 3-year follow-up, neither patient showed significant obstruction nor semilunar valve insufficiency.
Implications:
- Pulmonary autografts are a viable option for reconstructing complex LVOT obstruction in children.
- This technique provides excellent short-term valve function, relieves obstruction, avoids anticoagulation, and supports future patient growth.
Background:
Complex left ventricular outflow tract (LVOT) obstruction in children continues to pose a significant therapeutic challenge to cardiac surgeons. The Ross procedure, in combination with resection of subaortic stenosis or a Konno type septal incision, is an important option for these difficult patients.
Methods:
Recently two children aged 14 and 5 years with LVOT obstruction involving combined subaortic and valvar stenosis underwent surgical correction using the pulmonary autograft. Clinical presentation, operative technique, outcome and intermediate follow-up are detailed.
Results:
One patient had resection of an isolated subaortic membrane in combination with a pulmonary autograft and the second a Ross Konno procedure. Postoperative hospital stays were without complication. Both patients were discharged at 5 days and have no significant obstruction nor semilunar valve insufficiency at 3 years' follow-up.
Conclusions:
Pulmonary autografts can be used in combination with resection of subaortic tissue or a septal incision for reconstruction of complex left ventricular outflow tract obstruction. This technique renders excellent short term valve function, relief of obstruction, avoids anticoagulation and provides potential for future growth.