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[Aortic root replacement with pulmonary allograft (Ross procedure) in children. Early results]
István Hartyánszky1, András Kollár, András Szatmári
1Gottsegen György Országos Kardiológiai Intézet Gyermekszív Központ, Budapest. hartyanszky@hotmail.com
Insights
The Ross procedure is the preferred surgical option for children with congenital aortic valve disease. This study reports excellent early results in 12 pediatric patients, highlighting its effectiveness.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Context:
- Congenital aortic valve disease requires surgical intervention in infants and children.
- The Ross procedure, utilizing a pulmonary allograft, is a preferred method for aortic root replacement.
- This procedure addresses complex left ventricular outflow tract obstruction when necessary.
Purpose:
- To evaluate the efficacy and outcomes of the Ross procedure in pediatric patients with congenital aortic valve disease.
- To report the initial experience with the Ross and Konno procedures in Hungary for pediatric aortic valve disease.
- To assess the safety and success rate of pulmonary allograft use in children undergoing aortic valve replacement.
Summary:
- The study successfully applied the Ross procedure in 12 children (ages 2.5-17 years).
- One patient required a Konno extension and experienced early endocarditis, necessitating reoperation, but all patients survived and are well.
- This represents the first report of the Ross and Konno procedures in pediatric patients in Hungarian literature.
Impact:
- Demonstrates excellent early results for the Ross procedure in pediatric aortic valve disease.
- Supports the Ross procedure as the method of choice for treating aortic valve disease in children.
- Provides valuable data on the application of pulmonary allografts in pediatric cardiovascular surgery.
Introduction:
For infants and children with congenital aortic valve disease root replacement with pulmonary allograft (Ross procedure) is the preferred method of choice.
Patients/Results:
The authors have successfully applied this operation in 12 children (age range from 2.5 to 17 years--mean 9 years, body weight from 12 to 58 kg--mean 46 kg), one of whom has also required a Konno extension for long segment left ventricular outflow tract obstruction. The operation was complicated by early postoperative endocarditis in one case, and the child required redo homograft root replacement on the ninth postoperative day. All patients, including this one survived, and are doing well at present.
Conclusions:
In the Hungarian literature this is the first report on the Ross and Konno procedure in children. On the basis of our excellent early results, Ross procedure is the method of choice in aortic valve disease in children.