Preliminary experience with pulmonary autografts.
Between July 1994 and March 1995, seven patients (six male) with a mean age of 27 years (range 18 to 34 years) were selected for aortic valve replacement with a pulmonary autograft (Ross operation). The aortic valve disease was isolated insufficiency in four cases, stenosis in one and mixed lesion in two. Three patients had a bicuspid aortic valve. Previous cardiac surgical procedures had been performed in two cases (coarctation repair and valvuloplasty in one; isolated aortic valvuloplasty in one). Two patients were in NYHA class II and five in class III. In two cases the autograft was inserted as a scalloped subcoronary implant. Four patients had total aortic root replacement with re-implantation of the coronary ostia. The RVOT was reconstructed with a cryopreserved homograft (five pulmonary two aortic). The aortic cross-clamp time was 150 +/- 10 minutes with a total bypass time of 212 +/- 14 minutes. There was neither operative nor late mortality. Postoperative echocardiography revealed trivial autograft insufficiency in one case with a mean transvalvular gradient of 15.8 mmHg. All patients improved symptomatically (100% in NYHA class I). Freedom from reoperation, valve related complications and endocarditis is 100% at a mean follow up of 5.6 months (range 1-9 months). This preliminary experience supports the concept of pulmonary autograft implantation in selected patients.
Mazzucco
A
A
Department of Cardiovascular Surgery, University of Verona Medical School, Italy.
Santini
F
F
Fabbri
A
A
Dan
M
M
Campanile
F
F
Faggian
G
G
D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities / Q000601:surgery* / Q000637:transplantation; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002404:Catheterization; D018572:Disease-Free Survival; D015150:Echocardiography, Doppler; D004696:Endocarditis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011664:Pulmonary Valve / Q000601:surgery / Q000637:transplantation*; D012086:Reoperation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous