Ross procedure for complex left ventricular outflow tract obstruction.
BACKGROUND
Complex left ventricular outflow tract (LVOT) obstruction in children continues to pose a significant therapeutic challenge to cardiac surgeons. The Ross procedure, in combination with resection of subaortic stenosis or a Konno type septal incision, is an important option for these difficult patients.


METHODS
Recently two children aged 14 and 5 years with LVOT obstruction involving combined subaortic and valvar stenosis underwent surgical correction using the pulmonary autograft. Clinical presentation, operative technique, outcome and intermediate follow-up are detailed.


RESULTS
One patient had resection of an isolated subaortic membrane in combination with a pulmonary autograft and the second a Ross Konno procedure. Postoperative hospital stays were without complication. Both patients were discharged at 5 days and have no significant obstruction nor semilunar valve insufficiency at 3 years' follow-up.


CONCLUSIONS
Pulmonary autografts can be used in combination with resection of subaortic tissue or a septal incision for reconstruction of complex left ventricular outflow tract obstruction. This technique renders excellent short term valve function, relief of obstruction, avoids anticoagulation and provides potential for future growth.
Wilson
W R
WR
Department of Child Health, University of Missouri Health Sciences Center, Columbia 65212, USA.
Greer
G E
GE
Durzinsky
D S
DS
Curtis
J J
JJ
D000293:Adolescent; D006328:Cardiac Catheterization; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011664:Pulmonary Valve / Q000637:transplantation*; D013318:Stroke Volume; D014182:Transplantation, Autologous; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*