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The modified Ross operation using a Dacron prosthetic vascular jacket does prevent pulmonary autograft dilatation at 4.5-year follow-up.

Al Rashidi, Faleh; Bhat, Misha LU ; Höglund, Peter LU ; Meurling, Carl LU ; Roijer, Anders LU and Koul, Bansi LU (2010) In European Journal of Cardio-thoracic Surgery 37. p.928-933
Abstract
Objective: Following the Ross operation, pulmonary autografts tend to dilate over time. This study researches the fate of the pulmonary autograft - at 4.5 years following the modified Ross operation - with special reference to the impact of the modification on (a) pulmonary autograft dilatation, (b) the neo-aortic root geometry, (c) neo-aortic valve function and (d) the coronary artery reserve. Methods: A total of 26 patients who underwent the Ross operation were included in this study; of these, 13 consecutive patients underwent a modified Ross operation in which the free-standing autograft root was supported externally by a Dacron vascular prosthetic jacket (DVPJ). These patients were compared to a cohort of 13 matched patients who were... (More)
Objective: Following the Ross operation, pulmonary autografts tend to dilate over time. This study researches the fate of the pulmonary autograft - at 4.5 years following the modified Ross operation - with special reference to the impact of the modification on (a) pulmonary autograft dilatation, (b) the neo-aortic root geometry, (c) neo-aortic valve function and (d) the coronary artery reserve. Methods: A total of 26 patients who underwent the Ross operation were included in this study; of these, 13 consecutive patients underwent a modified Ross operation in which the free-standing autograft root was supported externally by a Dacron vascular prosthetic jacket (DVPJ). These patients were compared to a cohort of 13 matched patients who were operated on using the conventional Ross technique; all patients were followed up prospectively by echocardiography studies. The patients who underwent the modified Ross operation were also subjected to bicycle ergometry. Results: At the 47-month median follow-up, there was no significant increase in the size of the entire neo-aortic root in the patients who underwent the modified Ross operation; in addition, the geometry of the neo-aortic root was also preserved and the left ventricular function had improved significantly, whilst the aortic valve function and excursion remained satisfactory. All patients, with one exception, in the modified Ross operation group exhibited normal exercise capacity. By contrast, there were significant differences in diameters of the aortic root - between the two surgical techniques in favour of the modified Ross technique - following a median follow-up of 23 months in the patients subjected to the conventional Ross operation. Conclusions: Provision of external support to the entire pulmonary autograft with a DVPJ prevents its dilatation following free-standing pulmonary autograft Ross operation when evaluated at the 4.5-year follow-up. The function and the geometry of the neo-aortic root are not affected negatively by this modification and the patients demonstrated normal exercise capacity. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Cardio-thoracic Surgery
volume
37
pages
928 - 933
publisher
Elsevier
external identifiers
  • wos:000277047700035
  • pmid:20018521
  • scopus:77949486828
ISSN
1010-7940
DOI
10.1016/j.ejcts.2009.11.008
language
English
LU publication?
yes
id
ee71840e-d822-4bf9-88a3-cd5290f37619 (old id 1523530)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20018521?dopt=Abstract
date added to LUP
2010-01-12 13:22:00
date last changed
2018-05-29 09:59:59
@article{ee71840e-d822-4bf9-88a3-cd5290f37619,
  abstract     = {Objective: Following the Ross operation, pulmonary autografts tend to dilate over time. This study researches the fate of the pulmonary autograft - at 4.5 years following the modified Ross operation - with special reference to the impact of the modification on (a) pulmonary autograft dilatation, (b) the neo-aortic root geometry, (c) neo-aortic valve function and (d) the coronary artery reserve. Methods: A total of 26 patients who underwent the Ross operation were included in this study; of these, 13 consecutive patients underwent a modified Ross operation in which the free-standing autograft root was supported externally by a Dacron vascular prosthetic jacket (DVPJ). These patients were compared to a cohort of 13 matched patients who were operated on using the conventional Ross technique; all patients were followed up prospectively by echocardiography studies. The patients who underwent the modified Ross operation were also subjected to bicycle ergometry. Results: At the 47-month median follow-up, there was no significant increase in the size of the entire neo-aortic root in the patients who underwent the modified Ross operation; in addition, the geometry of the neo-aortic root was also preserved and the left ventricular function had improved significantly, whilst the aortic valve function and excursion remained satisfactory. All patients, with one exception, in the modified Ross operation group exhibited normal exercise capacity. By contrast, there were significant differences in diameters of the aortic root - between the two surgical techniques in favour of the modified Ross technique - following a median follow-up of 23 months in the patients subjected to the conventional Ross operation. Conclusions: Provision of external support to the entire pulmonary autograft with a DVPJ prevents its dilatation following free-standing pulmonary autograft Ross operation when evaluated at the 4.5-year follow-up. The function and the geometry of the neo-aortic root are not affected negatively by this modification and the patients demonstrated normal exercise capacity.},
  author       = {Al Rashidi, Faleh and Bhat, Misha and Höglund, Peter and Meurling, Carl and Roijer, Anders and Koul, Bansi},
  issn         = {1010-7940},
  language     = {eng},
  pages        = {928--933},
  publisher    = {Elsevier},
  series       = {European Journal of Cardio-thoracic Surgery},
  title        = {The modified Ross operation using a Dacron prosthetic vascular jacket does prevent pulmonary autograft dilatation at 4.5-year follow-up.},
  url          = {http://dx.doi.org/10.1016/j.ejcts.2009.11.008},
  volume       = {37},
  year         = {2010},
}