Spectrum and outcome of reoperations after the Ross procedure.
نویسندگان
چکیده
BACKGROUND Proposed advantages to the Ross procedure included presumed increased freedom from reoperation and simpler reoperation for pulmonary conduit replacement if needed. It is increasingly apparent, however, that reoperations are frequent after the Ross procedure and that when required, they may be more complex than previously thought. METHODS AND RESULTS Between September 1991 and August 2008, 56 patients underwent reoperation at our institution after a Ross procedure performed by ourselves (n=13) or elsewhere (n=43). Median age at first reoperation at our institution was 26 years (range 1 to 69 years). The 4 most common indications for reoperation were isolated autograft (neoaortic) regurgitation in 11 cases (20), isolated pulmonary conduit regurgitation/stenosis in 9 (16), combined autograft regurgitation/dilatation in 8 (14), and combined autograft regurgitation and pulmonary conduit regurgitation/stenosis in 6 (11). A total of 144 procedures were performed in these 56 patients during first reoperation at our institution. The autograft valve required replacement in 21 cases (38) and aortic root replacement in 21 (38), with ascending aortic/arch reconstruction in 13 (23) and mitral valve surgery in 5 (9). The pulmonary valve was replaced in 33 cases (59) and the tricuspid valve was repaired/replaced in 10 (18). Early mortality was 1.8 (1 of 56 patients), and morbidity included 6 patients with respiratory failure and 3 who required postcardiotomy extracorporeal membrane oxygenation. There were 4 late deaths during the median follow-up of 8 months (range 1 to 179 months). CONCLUSIONS A broad spectrum of complex reoperations may be required after the Ross procedure. Patients and family members considering the procedure should be informed of the potential for associated morbidity should reoperation be necessary.
منابع مشابه
Cardiac reoperations following the Ross procedure in children: spectrum of surgery and reoperation results.
OBJECTIVES The Ross procedure is the preferred aortic valve replacement (AVR) choice in small children. Nonetheless, it is a complicated surgery and there are concerns that subsequent cardiac reoperations are exceptionally complex and associated with high morbidity and mortality. We examine the surgical spectrum and report outcomes of cardiac reoperations in patients who had undergone the Ross ...
متن کاملعوامل خطر تنگی هموگرافت پولمونر پس ازعمل جراحی Ross
Background: The Ross procedure has been known as a good method for aortic valve replacement. Pulmonary allograft postoperative stenosis subsequent to the Ross procedure has been noted as an important disadvantage of this technique, although risk factors related to this complication are not clearly recognized. In this study we evaluate the risk factors of pulmonary allograft stenosis after Ross ...
متن کاملCAUSES OF MORTALITY IN CARDIAC SURGERY REOPERATIONS
From March 1990 to May 1993,309 patients underwent redo cardiac surgery operation at the Shahid Rajai Heart Hospital in Tehran. Early mortality rates in these patients showed a significant increase in comparison to patients undergoing open heart surgery for the first time. Late mortality (at least one month after surgery) in the patients was slightly increased also but less than early morta...
متن کاملThe Ross Procedure in Pediatric Patients: A 20-Year Experience of Ross Procedure in a Single Institution
BACKGROUND The Ross/Ross-Konno procedure is considered a good option for irreparable aortic valve disease in pediatric patients because of its hemodynamic performance and potential for growth of the pulmonary autograft. This study is a review of the long-term results of our 20-year experience with the Ross and Ross-Konno operations in a single institution. METHODS Between June 1995 and Januar...
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ورودعنوان ژورنال:
- Circulation
دوره 122 12 شماره
صفحات -
تاریخ انتشار 2010