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Pericardial collar modification for Ross procedure.

T Sarioglu¹, E Erek, Y K Yalçinbas

¹Istanbul Memorial Medical Center, Okmeydaniota, Istanbul, Turkey.

Cardiovascular Surgery (London, England)

|April 22, 2003

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A modified Ross operation using a pericardial collar addresses technical challenges in right ventricular outflow tract reconstruction. This technique enhances suture line integrity and manages bleeding, improving surgical outcomes.

Area of Science:

Cardiac surgery
Thoracic surgery
Cardiovascular procedures

Background:

The Ross operation, a complex cardiac surgery, involves pulmonary autograft replacement of the aortic valve.
Technical challenges persist in right ventricular outflow tract (RVOT) reconstruction during the Ross operation.
These include risks of first septal artery damage, weak posterior anastomotic areas, and septal dissection bleeding.

Purpose of the Study:

To present a modified surgical technique for the Ross operation.
To address specific technical difficulties encountered during RVOT reconstruction.
To improve the safety and efficacy of the pulmonary autograft procedure.

Main Methods:

A 1-cm wide pericardial strip (pericardial collar) was utilized.

Related Experiment Videos

The pericardial collar was sutured to the epicardium at the posterior and septal edges of the RVOT.

The outflow conduit was then anastomosed to this pericardial strip, particularly at the posterior aspect.

Main Results:

The pericardial collar technique created a robust and secure posterior suture line.
This modification effectively mitigated persistent bleeding from the septal dissection site.
The technique proved beneficial in overcoming key surgical challenges.

Conclusions:

The pericardial collar modification offers a valuable solution for RVOT reconstruction in the Ross operation.
This technique enhances surgical safety by reinforcing the anastomosis and controlling bleeding.
It represents a practical advancement in pulmonary autograft surgery.