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J Thorac Cardiovasc Surg 1996;112:433-436
© 1996 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

AORTIC VALVE REPLACEMENT WITH A PULMONARY AUTOGRAFT IN INFANTS WITH CRITICAL AORTIC STENOSIS

Supported by a grant from The Göteborg Medical Society.

Received for publication Oct. 23, 1995 Revisions requested Jan. 2, 1996; revisions received Feb. 5, 1996 Accepted for publication Feb. 7, 1996. Address for reprints: Laszlo Solymar, MD, Department of Pediatrics I, Section of Pediatric Cardiology, University of Göteborg, East Hospital, S-416 85 Göteborg, Sweden.

Abstract

Seven patients with critical aortic stenosis underwent aortic valve replacement with a pulmonary autograft (the Ross operation) between the ages of 5 weeks and 9 months. The operation was considered mandatory for survival because of continued severe heart failure or valve avulsion. Six of the patients had undergone unsuccessful previous palliations, such as commissurotomy, balloon dilation, and transventricular valvotomy, performed singly (n = 1) or in combination (n = 5). The other patient with a severely hypoplastic aortic valve ring underwent the Ross procedure as a primary operation. Two operative deaths occurred. In both cases severe endocardial fibroelastosis was detected at autopsy. One late death 1 year after the operation resulted from progressive hypertrophic cardiomyopathy and pulmonary hypertension. The rest of the patients are doing well, without medications. Apart from trivial regurgitation in two patients, the pulmonary autograft is performing well. (J THORAC CARDIOVASC SURG 1996;112:433-6)

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