title: Aortopulmonary size discrepancy is not a contraindication to the pediatric Ross operation.
abstract: BACKGROUND
  Modification of the aortic annulus or the ascending aorta, or both, may be required in pediatric patients undergoing the Ross operation. The fate of these autografts remains uncertain.
  
  
  METHODS
  Retrospective review of 15 patients undergoing Ross operation without aortic annular modification (group 1), 11 patients requiring annular reduction (group 2, n = 11), and 8 patients requiring annular enlargement (group 3, n = 8). Autograft function and dimensions were evaluated by echocardiography.
  
  
  RESULTS
  Autograft insufficiency was less than or equal to mild in 33 patients and moderate in 1 patient. The annulus body surface area ratio increased in group 1 from 19.7 +/- 5 to 20.3 +/- 5 mm/M2 (p = 0.8). The average annular reduction in group 2 was 5 +/- 1.5 mm, and 10 of 11 patients required reduction of the ascending aorta (mean 11 +/- 5 mm). The annulus body surface area ratio increased from 18.6 +/- 7 to 20.5 +/- 9 mm/M2 (p = 0.2). The mean augmentation in annulus diameter in group 3 was 6 +/- 4 mm; the annulus body surface area ratio decreased from 23.7 +/- 14 to 20.3 +/- 8 mm/M2 (p = 0.5).
  
  
  CONCLUSIONS
  We continue to offer the Ross operation to pediatric patients even when aortic annular or ascending aortic size discrepancies mandate surgical modifications.
authors.affiliation: Pediatric Cardiothoracic Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania 15213, USA. pigulaf@heart.chp.edu
authors.forename: F A
authors.initials: FA
authors.lastname: Pigula
authors.forename: J
authors.initials: J
authors.lastname: Paolillo
authors.forename: M
authors.initials: M
authors.lastname: McGrath
authors.forename: S K
authors.initials: SK
authors.lastname: Gandhi
authors.forename: J L
authors.initials: JL
authors.lastname: Myers
authors.forename: B
authors.initials: B
authors.lastname: Rebovich
authors.forename: R D
authors.initials: RD
authors.lastname: Siewers
mesh_terms: D000293:Adolescent; D001011:Aorta / Q000033:anatomy & histology*; D001021:Aortic Valve / Q000637:transplantation*; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D006801:Humans; D007223:Infant; D011651:Pulmonary Artery / Q000033:anatomy & histology*; D012189:Retrospective Studies