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Related Experiment Videos

Aortic root replacement with a pulmonary autograft

R B Hokken1, A J Bogers, M A Taams

  • 1Department of Cardio-thoracic Surgery, University Hospital Sophia-Dijkzigt, Rotterdam, The Netherlands.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 1, 1995
PubMed
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Pulmonary autograft aortic root replacement shows promising medium-term results in young patients, with low mortality and good functional outcomes. This aortic valve repair technique avoids reoperations for technical issues.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Pediatric Cardiology

Background:

  • Aortic root aneurysms and dissections often require surgical intervention.
  • The Ross procedure, utilizing a pulmonary autograft, is a viable option for aortic root replacement, particularly in younger patients.
  • Long-term outcomes and potential complications of the pulmonary autograft require continued investigation.

Purpose of the Study:

  • To evaluate the medium-term outcomes of aortic root replacement using the pulmonary autograft in a consecutive series of patients.
  • To assess mortality, morbidity, and functional status following this procedure.
  • To analyze echocardiographic findings and identify potential complications such as autograft failure or stenosis.

Main Methods:

  • A retrospective review of 42 consecutive patients undergoing aortic root replacement with a pulmonary autograft.

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  • Data collection included in-hospital and late mortality, reoperations, and complications.
  • Follow-up assessments included clinical evaluation, echocardiography, and assessment of New York Heart Association (NYHA) functional class.

    • Main Results:

    • Hospital mortality was 4.8% (2 patients), unrelated to the autograft. Mean follow-up was 30 months.
    • Late mortality was 2 patients; one experienced autograft failure due to rheumatoid arthritis.
    • Estimated 4-year survival was 88.8%. Morbidity included 3 patients; 2 required reoperation for autograft failure or stenosis. No thromboembolic events or endocarditis were observed. Estimated 4-year event-free survival was 78.7%.
    • Echocardiography showed autograft annulus dilation (2.9 mm increase). 35/37 patients were in NYHA class I or II. No significant aortic regurgitation or stenosis was noted.

    Conclusions:

    • Pulmonary autograft aortic root replacement demonstrates promising medium-term results regarding mortality, morbidity, and functional outcomes.
    • The procedure appears safe and effective, with a low rate of reoperations for technical or degenerative reasons.
    • Further long-term studies are warranted to fully assess the durability and potential late complications of the pulmonary autograft.