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J Thorac Cardiovasc Surg 2007;133:1316-1317
© 2007 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Discussion

Dr Lamberti (San Diego, Calif). Dr Hawkins and his colleagues have reported their results for aortic or systemic semilunar valve repair in infants and children since 1991. If we look back over the past 20 years, we can identify 2 other operations that were proposed for aortic valve disease in infants and children that have not withstood the test of time. After 1985, aortic homograft valves were generally available for use in infants and children. In addition, the general availability of homograft valves led to enthusiasm for the Ross operation as a potentially curative operation for children. At the meeting of this association in June 1992 in Kauai, Hawaii, Dr David Clarke reported on his extensive experience with aortic valve homografts in young patients. Dr Clarke reported that cryopreserved aortic valve homografts degenerated rather quickly in infants and children less than 3 years of age. For many of us the Ross operation seemed to offer an excellent option for the treatment of important aortic valve disease in infants, children, and young adults. Mid- to long-term follow-up of patients undergoing the Ross operation has not supported the concept that replacing the aortic valve with the native pulmonary valve with the technique of root replacement is a durable substitute for the aortic valve. Today the surgeon confronted with a severe case of systemic semilunar valve insufficiency has no ideal option for treatment, particularly in infants and small children. Although the neonatal Ross operation can save the life of an infant, the patient will face multiple reoperations on the right ventricular outflow tract and the possibility that late replacement of the aortic graft will be . . . [Full Text of this Article]

Related Article

Intermediate-term results of repair for aortic, neoaortic, and truncal valve insufficiency in children

John A. Hawkins, Peter C. Kouretas, Richard Holubkov, Richard V. Williams, Lloyd Y. Tani, Jason T. Su, Linda M. Lambert, Christopher R. Mart, Michael D. Puchalski, and L. LuAnn Minich
J. Thorac. Cardiovasc. Surg. 2007 133: 1311-1317. [Abstract] [Full Text] [PDF]