Extended aortic root replacement with pulmonary autografts: experience in 14 cases.
The surgical relief of complex multilevel left ventricular outflow tract obstruction remains a challenging problem. We present a new operation that combines the concepts of aortoventriculoplasty, extended aortic root replacement, and the use of a pulmonary autograft. Fourteen patients underwent this operation: 9 patients after previous attempts to relieve diffuse subvalvular stenosis and 5 patients who had excessive gradients over an outgrown aortic valve prosthesis. All patients except 1 survived the operation. Complete heart block developed in 1 patient after a septal infarction. One patient remained in congestive heart failure and died suddenly after 17 months. All other patients are in New York Heart Association class I after a mean follow-up of 20 +/- 12 months. All patients showed excellent function of the autograft and homograft valve at follow-up. This operation might present a more durable or even a definitive solution in the management of these complex left ventricular outflow tract obstructions.
Daenen
W J
WJ
Department of Cardiac Surgery, Gasthuisberg University Hospital, Leuven, Belgium.
Vanhove
M A
MA
Gewillig
M H
MH
D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D006801:Humans; D011183:Postoperative Complications; D011664:Pulmonary Valve / Q000637:transplantation*; D014182:Transplantation, Autologous / Q000379:methods; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery