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Ross operation for active culture-positive aortic valve endocarditis with extensive paravalvular involvement
A Prat1, J I Saez de Ibarra, A Vincentelli
1Department of Cardiac Surgery, Cardiologic Hospital, University of Lille, France. aprat@chru-lille.fr
Background:
We evaluated the midterm results of the Ross operation in active advanced endocarditis.
Methods:
Between June 1994 and June 2000 a pulmonary autograft aortic root replacement was performed in 11 consecutive patients who had urgent or emergent procedures for active endocarditis with extensive involvement of the aortic root (10 native, 1 prosthetic). Patients ranged in age from 26 to 45 years (median, 33 years). Indications for operation were uncontrolled infection (n = 5), hemodynamic deterioration (n = 3), or both (n = 3). Four patients were in the New York Heart Association class III, 6 in class IV, and 1 was operated on while in cardiogenic shock. Four patients (36%) suffered an embolic cerebrovascular accident preoperatively. The endocarditis affected the mitral valve in 2 patients and the tricuspid valve in 1 patient.
Results:
There was no early or late death. Recurrent endocarditis was not detected in any of the patients during the follow-up period ranging up to 72 months (median, 40 months).
Conclusions:
The autograft may well be the best substitute for aortic root reconstruction in advanced endocarditis.