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Neoaortic valve and root complex evolution after Ross operation in infants, children, and adolescents

Alessandro Frigiola1, Alessandro Varrica, Angela Satriano

  • 1Department of Cardiac Surgery, IRCCS Policlinico S. Donato, Milan, Italy.

The Annals of Thoracic Surgery
|September 28, 2010
PubMed

Insights

The Ross operation is a viable option for pediatric aortic valve disease. While neoaortic dilation occurs, it doesn't cause valve insufficiency, the primary reason for reoperation.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Aortic Valve Disease

Background:

  • The Ross operation offers advantages for children and adolescents with aortic valve disease.
  • Concerns exist regarding long-term neoaortic complex development and dilation risk.

Purpose of the Study:

  • To evaluate the long-term outcomes of the Ross operation in pediatric patients.
  • To assess neoaortic complex development, valve function, and reoperation rates.

Main Methods:

  • Retrospective analysis of prospectively collected data from 95 patients under 18 years old who underwent the Ross operation.
  • Median follow-up of 84 months, analyzing echocardiographic and clinical data.

Main Results:

  • Neoaortic root and sinotubular junction dilation exceeded somatic growth; neoaortic valve growth mirrored somatic proportions.
  • Freedom from moderate neoaortic root dilation was 100% at 5 years and 77% at 10 years.
  • Freedom from moderate neoaortic valve insufficiency was 86% at 5 years and 63% at 10 years; freedom from reintervention was 96% at 5 years and 80% at 10 years.

Conclusions:

  • The Ross operation is a viable option for severe aortic valve disease in children and adolescents.
  • Neoaortic complex dilation occurs but is not the primary driver of neoaortic valve insufficiency.
  • Neoaortic valve insufficiency is the main indication for reoperation after the Ross procedure.
Abstract

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