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J Thorac Cardiovasc Surg 2007;133:817-818
© 2007 The American Association for Thoracic Surgery

Brief Communication

Dissection of a dilated autograft root

^a Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
^b Department of Cardiothoracic Surgery, University Medical Center, Utrecht, The Netherlands.

^_* Address for reprints: Loes M. A. Klieverik, MD, Department of Cardiothoracic Surgery, Bd 571, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. (Email: l.klieverik@erasmusmc.nl).

The first 20% of the full text of this article appears below.

Although the Ross procedure is still the preferred operation for aortic root replacement in children and young adults, the number of reoperations for autograft root dilatation after the Ross procedure has increased in recent years.^1-4

In our ongoing prospective clinical and echocardiographic follow-up study of 146 consecutive patients undergoing a Ross procedure with the root replacement technique since 1988, 29 patients have undergone pulmonary autograft reoperations to date. In most cases valve cusps are intact, but because of progressive autograft root dilatation coaptation of the cusps is lost and aortic valve regurgitation occurs.

We report a patient who presented with severe aortic regurgitation due to asymmetric autograft dilatation caused by a dissection in the noncoronary sinus of Valsalva.

Clinical Summary

A 50-year-old woman with a bicuspid native aortic valve, symptomatic moderate aortic regurgitation, and a dilated left ventricle with good systolic function returned for reoperation 9 years after undergoing a modified Ross procedure with the root replacement technique. The patient had symptoms of fatigue and dyspnea on exertion. Echocardiographic examination 4 months before . . . [Full Text of this Article]

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