Clinical outcomes and indicators of normalization of left ventricular dimensions after Ross procedure in children.
Between 1993 and 2000, 50 patients (age range, 1 month to 18 years) who had left ventricular outflow tract (LVOT) disease and had undergone a Ross procedure were assessed using echocardiography. Aortic annulus size, valvular gradient, valve insufficiency, LV dimensions at end-systole and end-diastole, LV interventricular septal and posterior wall thickness, and LV mass index (LVMI) were measured. There was 1 early and 2 late deaths, and 5 reoperations. Aortic annulus size increased and degree of aortic insufficiency (AI) decreased, as did LV internal dimensions and LVMI. Peak pressure gradients declined from 73 +/- 18 mm Hg to 7 +/- 7 mm Hg, and LVMI regressed (167 +/- 6 g/m(2) v 108 +/- 6 g/m(2), P <.001) after 3 years. The degree of AI ranged from none to mild, and no patient has LVOT stenosis. Regression of LV dilatation and hypertrophy, good autograft valve function and durability, and a high survival rate suggest that the Ross procedure is preferred for most children who require aortic valve replacement.
Brown
J W
JW
Section of the Cardiothoracic Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Ruzmetov
M
M
Vijay
P
P
Bills
R G
RG
Turrentine
M W
MW
D000293:Adolescent; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000592:standards; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000637:transplantation*; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000601:surgery*; D016277:Ventricular Function, Left; D014694:Ventricular Outflow Obstruction / Q000503:physiopathology / Q000601:surgery