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Destino de la raíz aórtica después de la operación de Ross

Giovanni Battista Luciani¹, Gianluca Casali, Alessandro Favaro

¹Division of Cardiac Surgery, University of Verona, Italy. gbluciani@yahoo.com

|September 13, 2003

Resumen

La dilatación del autoinjerto es común después del procedimiento de Ross, especialmente en pacientes más jóvenes. Esto puede conducir a una disfunción de la válvula del autoinjerto, aunque la reoperación es poco frecuente.

Área de la Ciencia:

Cirugía cardiovascular La cirugía cardiovascular es una cirugía cardiovascular.
Cirugía torácica cirugía torácica.
Cirugía cardíaca Cirugía cardíaca.

Sus antecedentes:

El procedimiento de Ross es una alternativa al reemplazo mecánico de la válvula aórtica en pacientes jóvenes.
Se ha observado una dilatación temprana de la raíz del autoinjerto pulmonar después del procedimiento de Ross.
Este estudio investiga la dilatación tardía del autoinjerto, sus factores de riesgo y consecuencias.

Objetivo del estudio:

Para determinar la prevalencia de la dilatación tardía del autoinjerto después del procedimiento Ross.
Para identificar los factores de riesgo asociados con la dilatación del autoinjerto.
Para evaluar las consecuencias de la dilatación del autoinjerto en la función de la válvula y las tasas de reoperación.

Principales métodos:

Revisión de todos los pacientes consecutivos que se sometieron al procedimiento de Ross desde mayo de 1994.
Exámenes clínicos y ecocardiográficos para pacientes con al menos 1 año de seguimiento.
Análisis estadístico que incluye análisis de riesgo proporcional de Cox para identificar factores predictivos.

Principales resultados:

La dilatación tardía del autoinjerto se identificó en el 34% de los pacientes.
La edad más joven, el seno preoperatorio de Valsalva, la técnica de reemplazo de raíz y la ausencia de refuerzo pericárdico predijeron la dilatación.
La regurgitación del autoinjerto ocurrió en el 14% de los pacientes, más prevalente en aquellos con dilatación.

Conclusiones:

La dilatación del autoinjerto es común tarde después del procedimiento de Ross, particularmente en pacientes más jóvenes y en aquellos con aneurisma aórtico preoperatorio.
La válvula aórtica bicúspide no es un factor de riesgo para la dilatación.
La disfunción significativa de la válvula del autoinjerto es más frecuente en pacientes con dilatación del autoinjerto.

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