[Ross procedure with combined replacement of the ascending aorta: impact on autograft root function and distensibility].
BACKGROUND
The safety and effectiveness of combined aortic root autograft replacement in combination with ascending aorta replacement has been demonstrated recently. Replacement of the ascending aorta with a vascular prosthesis results in an increase in aortic root distension, and aortic root wall stress. In this study we aimed to assess the autograft root dimensions, distensibility, and autograft valve function in patients after Ross operation combined with replacement of the ascending aorta compared to patients who underwent Ross operation only.


METHODS
Echocardiographic follow-up was performed on 28 patients after Ross operation with complete root replacement only (group R) and 12 patients who received an additional replacement of the ascending aorta (group R/A). The mean follow-up time was 24.9 +/- 17.2 months. Autograft root dimensions, root distensibility and valve function were assessed by echo-cardiography. The aortic root was measured at the level of the annulus, sinus of valsalva, and sinotubular junction. The distensibility was calculated as percent change of radius.


RESULTS
The mean distensibility at the annulus level was higher in group R/A (18.4 +/- 6.8% vs 13.4 +/- 8.1%; p = 0.047); at the level of the sinus of valsalva and sinotubular junction no differences were observed. The autograft pressure gradient was within physiological limits in all patients. The majority of patients showed a competent autograft valve (group R: AI 0 degree; 83%, AI I degree; 14%, AI II degree; 3%; group R/A: AI 0 degree; 75%, AI I degree; 25%).


CONCLUSIONS
Replacement of the ascending aorta with a non-compliant prosthesis does not effect root dimension, distensibility, and valve function.
Leyh
R G
RG
Medizinische Hochschule Hannover Carl-Neuberg-Str. 1 30623 Hannover, Germany. leyh@thg.mh-hannover.de
Kofidis
T
T
Hagl
C
C
Fischer
S
S
Knobloch
K
K
Akhyari
P
P
Karck
M
M
Haverich
A
A
D000328:Adult; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001807:Blood Vessel Prosthesis; D016009:Chi-Square Distribution; D004452:Echocardiography; D004548:Elasticity; D005500:Follow-Up Studies; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D011093:Polyethylene Terephthalates; D011664:Pulmonary Valve / Q000637:transplantation*; D013997:Time Factors; D014182:Transplantation, Autologous
D011093:Polyethylene Terephthalates
Aorta ascendens-Ersatz und Ross-Operation: Einfluss auf die Distensibilität der Neo-Aortenwurzel.