Aortic Valve Replacement by Pulmonary Autogrbft: Technical Advances and Follow-up.
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Date
2011
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Abstract
Background: Autograft is the best choice of graft material in every place especially in cardiac
surgery to avoid all type of anti-coagulant related hazard, immunological reactions and considering
cost involvement. Study was designed on the basis of above facts.
Methods: All patients underwent surgery with standard Cardiopulmonary By-pass under moderate
hypothermia using median stemotomy incision. Aortic valve was excised and the right and left
coronary buttons were fashioned. Also the pulmonary root was excised. A running suture technique
was used to insert the autograft in to the aortic annulus. A pulmonary homograft made by pericardium
with three pulmonary valves of appropriate size (22-29 mm) was then inserted.
Results: Between July 2001 to July 2002, 30 patients underwent the modified Ross Procedure at La-
Pitie Salpitriere Hospital, Paris, France. Out of 30 patients 16 were male and 14 were female with the
mean age of 29 years. Indication of operation was aortic stenosis in 6 cases, aortic insufficiency in 9
cases and mixed aortic valve lesion in 15 cases. The mean intra operative cross clamp time was 120
minutes (range: 70-170 minutes), mean cardiopulmonary bypass time was 150 minutes (range: 110-
195 minutes). Postoperativee chocardiogramsr evealed no significant pulmonary or aortic valvular
dysfunction. Three patients, early in the series required reopening for post operative bleeding.
Overall a mean of 2.5 units of bloods (0-10) were transfused per patient. Atrial fibrillation occurred
in 2 patients which wsre managed accordingly. Among 30 patients, there was one perioperative
death (3%), one patient was lost to follow-up and one patient refused to late post operative
echocardiography. Twenty four caseso ut of the twenty seven patients available for functional
follow-up were in NYHA class I, 2 patients in NYHA class II and one patient in NYHA class III.
Conclusions: Pulmonary autografts in aortic position give good short-term result but for its long
{erm effrcacy and safety needs more study.
Description
Keywords
Aortic valve, Pulmonary Autograft, Autograft, Ross procedure.
Citation
Aftabuddin M, Khan O S, Rama A A, Acar C, Pavee A, Grandjbakhch I. Aortic Valve Replacement by Pulmonary Autogrbft: Technical Advances and Follow-up. Cardiovascular Journal. 2011; 4(1): 58-60.