A 6-year experience of the Ross procedure in children with congenital aortic valve disease

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Abstract

Background: The choice of an optimal method for correction of aortic valve stenosis or insufficiency remains the matter of debate. Some clinicians prefer transluminal balloon angioplasty, some would perform an open type commissurotomy, or aortic valve replacement, or to valve leaflets repair with various materials, while others opt for the Ross procedure. Each of these techniques has its advantages and disadvantages both in the early postoperative period and in the long-term.

Aim: To assess the results of the Ross procedure, its complications, survival, and probability of reoperations in the long-term.

Materials and methods: We retrospectively analyzed the results of 32 Ross procedures performed from the end of 2012 to the beginning of 2019 in children aged from 3 days to 18 years. Eight children were below 1 year of age, including one newborn. A pulmonary autograft was placed into the aortic position in all children. In 31 children, a homograft was placed into the pulmonary artery. In one patient, an aortic autograft was implanted instead of the pulmonary artery valve. The mean patient age was 6.8 years, mean bodyweight 27.7 kg (range, 3.9–74.6 kg).

Results: Two patients died in the early postoperative period (mortality 6.25%). We examined 26 patients at the follow-up, with its mean duration of 2.5 years. There were no indications for replacement of the homograft during the follow-up. One patient, in whom we had implanted an aortic autograft into the pulmonary position, required its replacement after 4.5 years. We have no data on death rates in the long-term.

Conclusion: The Ross procedure provides satisfactory results in the early and intermediate postoperative period. Continuous follow-up is needed to determine the time points and the proportion of repeated interventions with a pulmonary homograft and aortic valve.

About the authors

D. S. Akatov

Federal Center of High Medical Technology

Author for correspondence.
Email: adeniss@mail.ru
ORCID iD: 0000-0002-8401-2556

Denis S. Akatov – MD, PhD, Cardiovascular Surgeon, Department of Cardiosurgery No. 3 

4 Kaliningradskoe shosse, poselok Rodniki, Gur'evskiy rayon, Kaliningradskaya oblast', 238312

Russian Federation

V. A. Belov

Federal Center of High Medical Technology

Email: fake@neicon.ru
ORCID iD: 0000-0002-0945-8208

Vyacheslav A. Belov – Head of Department of Cardiosurgery No. 3 

4 Kaliningradskoe shosse, poselok Rodniki, Gur'evskiy rayon, Kaliningradskaya oblast', 238312

Russian Federation

D. E. Khomich

Federal Center of High Medical Technology

Email: fake@neicon.ru
ORCID iD: 0000-0002-1257-9043

Dina E. Khomich – Cardiologist, Department of Cardiosurgery No. 3 

4 Kaliningradskoe shosse, poselok Rodniki, Gur'evskiy rayon, Kaliningradskaya oblast', 238312

Russian Federation

O. N. Bukhareva

Federal Center of High Medical Technology

Email: fake@neicon.ru
ORCID iD: 0000-0002-4041-4641

Olga N. Bukhareva – MD, PhD, Cardiologist, Department of Cardiosurgery No. 3 

4 Kaliningradskoe shosse, poselok Rodniki, Gur'evskiy rayon, Kaliningradskaya oblast', 238312

Russian Federation

A. A. Makarov

Federal Center of High Medical Technology

Email: fake@neicon.ru
ORCID iD: 0000-0003-3112-5191

Andrey A. Makarov – Head of Department of Anaesthesiology and Intensive Care No. 1 

4 Kaliningradskoe shosse, poselok Rodniki, Gur'evskiy rayon, Kaliningradskaya oblast', 238312

Russian Federation

S. N. Kotov

Federal Center of High Medical Technology

Email: fake@neicon.ru
ORCID iD: 0000-0002-4027-4159

Sergey N. Kotov – Head of Department of Functional Diagnostics 

4 Kaliningradskoe shosse, poselok Rodniki, Gur'evskiy rayon, Kaliningradskaya oblast', 238312

Russian Federation

Yu. A. Schneider

Federal Center of High Medical Technology

Email: fake@neicon.ru
ORCID iD: 0000-0002-5572-3076

Yuri A. Schneider – MD, PhD, Professor, Chief Physician 

4 Kaliningradskoe shosse, poselok Rodniki, Gur'evskiy rayon, Kaliningradskaya oblast', 238312

Russian Federation

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Copyright (c) 2020 Akatov D.S., Belov V.A., Khomich D.E., Bukhareva O.N., Makarov A.A., Kotov S.N., Schneider Y.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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