Pulmonary autograft for mitral valve replacement in infants: the Ross-Kabbani operation

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Valvular Heart Disease

Background:

• Infants with severe mitral valve dysplasia often present with critical heart failure, necessitating surgical intervention.
• Traditional surgical options like repair or mechanical prosthesis implantation are frequently unsuitable for very young infants due to anatomical limitations and anticoagulation challenges.

Observation:

• Two infants, aged 6 and 2.5 months, presented with severe mitral valve dysplasia, leading to significant valvular insufficiency and heart failure.
• The specific anatomical features of their mitral valves precluded repair, and mechanical prostheses were contraindicated due to age and anticoagulation concerns.

Findings:

• A Ross-Kabbani intervention, involving pulmonary autograft implantation in the mitral position and a pulmonary homograft, was performed in both infants.
• Both patients experienced a postoperative course free of major complications.
• Short-term follow-up demonstrated good function of the pulmonary autograft in the mitral position.

Implications:

• The Ross-Kabbani procedure with a pulmonary autograft represents a promising surgical strategy for managing severe mitral valve dysplasia in infants when other options are not feasible.
• This technique may offer a durable solution, avoiding the long-term complications associated with mechanical valves in pediatric populations.
• Further research and long-term follow-up are warranted to fully assess the durability and efficacy of this approach in pediatric valvular heart disease.