Mechanism of autograft insufficiency after the Ross operation in children

It is unclear how autografts grow and dilate after the Ross operation in children. We analysed autograft growth and dilatation in children who underwent the Ross operation and examined the relationship of these factors to autograft failure. From our institutional database, we retrospectively identif...

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Bibliographic Details
Published in:Cardiology in the young 2013-08, Vol.23 (4), p.523-529
Main Authors: Goda, Motohiko, Gewillig, Marc, Eyskens, Benedicte, Heying, Ruth, Cools, Bjorn, Rega, Filip, Meyns, Bart
Format: Article
Language:English
Subjects:
Adolescent
Aortic Valve Insufficiency - diagnostic imaging
Aortic Valve Insufficiency - physiopathology
Aortic Valve Insufficiency - surgery
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - physiopathology
Aortic Valve Stenosis - surgery
Autografts - diagnostic imaging
Autografts - physiopathology
Child
Child, Preschool
Cohort Studies
Dilatation, Pathologic - diagnostic imaging
Dilatation, Pathologic - physiopathology
Echocardiography
Female
Humans
Infant
Male
Original Articles
Pulmonary Valve - transplantation
Retrospective Studies
Transplantation, Autologous
Treatment Outcome
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Summary:It is unclear how autografts grow and dilate after the Ross operation in children. We analysed autograft growth and dilatation in children who underwent the Ross operation and examined the relationship of these factors to autograft failure. From our institutional database, we retrospectively identified 33 children who underwent the Ross operation without aortic root reinforcement (mean age 9.9 years) and had normal body measurements and echocardiographic data throughout follow-up. Autograft insufficiency developed in 10 patients 5.1 years after the Ross operation. The average Z score at the development of autograft insufficiency was -0.1 (range from -2.0 to 6.1). The proportions of patients who remained free of autograft insufficiency at 5 and 10 years were 87.2% and 55.7%, respectively. A consistent trend in the time course of Z score was not found in any age group studied. Autograft growth and dilation after the Ross operation varied widely among patients, and the incidence of autograft insufficiency was independent of annulus size.
ISSN:1047-9511
1467-1107
DOI:10.1017/S1047951112001783