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Mechanism of autograft insufficiency after the Ross operation in children

Published online by Cambridge University Press:  31 October 2012

Motohiko Goda ,
Marc Gewillig ,
Benedicte Eyskens ,
Ruth Heying ,
Bjorn Cools ,
Filip Rega  and
Bart Meyns
Motohiko Goda*
Affiliation:
Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium Department of Cardiothoracic Surgery, Yokohama City University Hospital, Kanazawa-ku, Yokohama, Japan
Marc Gewillig
Affiliation:
Department of Pediatric Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium
Benedicte Eyskens
Affiliation:
Department of Pediatric Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium
Ruth Heying
Affiliation:
Department of Pediatric Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium
Bjorn Cools
Affiliation:
Department of Pediatric Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium
Filip Rega
Affiliation:
Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
Bart Meyns
Affiliation:
Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
*
Correspondence to: Dr M. Goda, MD, Department of Cardiac Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. Tel: +3216344260; Fax: +3216344616; E-mail: gogomotto@livedoor.com
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Abstract

Background

It is unclear how autografts grow and dilate after the Ross operation in children. We analysed autograft growth and dilatation in children who underwent the Ross operation and examined the relationship of these factors to autograft failure.

Methods

From our institutional database, we retrospectively identified 33 children who underwent the Ross operation without aortic root reinforcement (mean age 9.9 years) and had normal body measurements and echocardiographic data throughout follow-up.

Results

Autograft insufficiency developed in 10 patients 5.1 years after the Ross operation. The average Z score at the development of autograft insufficiency was −0.1 (range from −2.0 to 6.1). The proportions of patients who remained free of autograft insufficiency at 5 and 10 years were 87.2% and 55.7%, respectively. A consistent trend in the time course of Z score was not found in any age group studied.

Conclusions

Autograft growth and dilation after the Ross operation varied widely among patients, and the incidence of autograft insufficiency was independent of annulus size.

Keywords

Congenital valve diseaseaortic valvepulmonary valvechildZ scoreKaplan–Meier method
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 4 , August 2013 , pp. 523 - 529
Copyright
Copyright © Cambridge University Press 2012 

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