Autograft Wrapping Reinforcement in Adolescents Undergoing Ross Operation: A Tailored Coat.
Journal
The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
received:
23
11
2020
revised:
24
04
2021
accepted:
24
05
2021
pubmed:
5
7
2021
medline:
1
9
2022
entrez:
4
7
2021
Statut:
ppublish
Résumé
The Ross operation is a good surgical option for the pediatric population with aortic valve disease. However, the need for reoperation due to aortic root dilatation remains the principal limitation of this procedure. We report a small series of adolescents who underwent the Ross operation with Gore-Tex (W. L. Gore & Associates, Flagstaff, AZ) membrane reinforcement to avoid the progressive dilatation of the neoaortic root. Between March 2002 and March 2010, 15 adolescent patients underwent a modified Ross procedure with the autograft wrapping with 0.1-mm Gore Preclude (W. L. Gore & Associates) pericardial membrane. Follow-up was performed by clinical and echocardiographic controls. These patients were a mean age of 15 ± 1.4 years. The mean aortic cross-clamp time was 130 ± 17 minutes. The mean cardiopulmonary bypass time was 187 ± 27 minutes. There was no hospital mortality. The mean follow-up was 15 ± 2.5 years (range, 9.7-17.7 years). During the follow-up, 1 patient required aortic valve reoperation for cusps prolapse. The mean diameters of annulus (22.8 ± 1.8 mm vs 23.3 ± 1.5 mm, P = .12), aortic root (27.4 ± 1.4 mm vs 28.2 ± 0.8 mm, P = .09), and sinotubular junction (24.3 ± 1.1 mm vs 25.1 ± 0.7 mm, P = .11) were not statistically different between discharge and follow-up. The wrapping reinforcement autograft in the Ross procedure with Gore-Tex membrane is simple, safe, and does not require significant additional time. Our results showed good early and long-term outcomes for reoperation, aortic root dilatation, and aortic valve degeneration.
Sections du résumé
BACKGROUND
The Ross operation is a good surgical option for the pediatric population with aortic valve disease. However, the need for reoperation due to aortic root dilatation remains the principal limitation of this procedure. We report a small series of adolescents who underwent the Ross operation with Gore-Tex (W. L. Gore & Associates, Flagstaff, AZ) membrane reinforcement to avoid the progressive dilatation of the neoaortic root.
METHODS
Between March 2002 and March 2010, 15 adolescent patients underwent a modified Ross procedure with the autograft wrapping with 0.1-mm Gore Preclude (W. L. Gore & Associates) pericardial membrane. Follow-up was performed by clinical and echocardiographic controls.
RESULTS
These patients were a mean age of 15 ± 1.4 years. The mean aortic cross-clamp time was 130 ± 17 minutes. The mean cardiopulmonary bypass time was 187 ± 27 minutes. There was no hospital mortality. The mean follow-up was 15 ± 2.5 years (range, 9.7-17.7 years). During the follow-up, 1 patient required aortic valve reoperation for cusps prolapse. The mean diameters of annulus (22.8 ± 1.8 mm vs 23.3 ± 1.5 mm, P = .12), aortic root (27.4 ± 1.4 mm vs 28.2 ± 0.8 mm, P = .09), and sinotubular junction (24.3 ± 1.1 mm vs 25.1 ± 0.7 mm, P = .11) were not statistically different between discharge and follow-up.
CONCLUSIONS
The wrapping reinforcement autograft in the Ross procedure with Gore-Tex membrane is simple, safe, and does not require significant additional time. Our results showed good early and long-term outcomes for reoperation, aortic root dilatation, and aortic valve degeneration.
Identifiants
pubmed: 34217690
pii: S0003-4975(21)01093-6
doi: 10.1016/j.athoracsur.2021.05.087
pii:
doi:
Substances chimiques
Polytetrafluoroethylene
9002-84-0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
866-871Commentaires et corrections
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Informations de copyright
Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.