Ross procedure in adults

Ross procedure (pulmonary autograft for aortic position) was used for aortic valve disease initially in children and later in adults. The pulmonary valve along with part of the main pulmonary artery is taken and made into a neo-aortic root. Either a cryopreserved homograft or xenograft is placed in the pulmonary position. Sometimes a polytetrafluoroethylene (PTFE) conduit is used in the pulmonary position. The advantage of the autograft in children is that it would grow in size as the child grows, unlike a prosthetic valve. A recent study has reported 90.7% ten year survival after Ross procedure in adults [1]. Dilated aortic root can lead to aortic regurgitation in some cases. Aortic dissection 16 years after Ross procedure has been reported [2]. In this case it was successfully repaired. Authors mention that it is more likely to occur in individuals who had bicuspid aortic valve as they may have associated connective tissue abnormalities predisposing to aortic dissection. Xenografts are more likely to fail than cryopreserved homografts in the pulmonary position. Christ T et al [3] noted that freedom from pulmonary valve reoperation at 15 years was 100% with homografts while it was 78.9 ± 9.4% with stentless xenografts. Freedom from aortic valve reoperation at 15 years was similar in both groups, at around 85%. But the availability of homografts is often limited in most centers. A comparison of Ross procedure with mechanical aortic valve replacement in young and mid...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiac Surgery Cardiology Source Type: blogs