title: Modified Ross operation with reinforcement of the pulmonary autograft: Six-year results.
abstract: OBJECTIVE
  The Ross procedure is widely used for aortic valve disease in patients who are still growing and young adults with active lifestyles or the desire for pregnancy. The need for autograft reoperation remains the principal limitation of the procedure. Autograft inclusion in a polyester tube prosthesis has been proposed with good postoperative results, but the durability of these technical modifications has not been assessed. We report the midterm results of pulmonary autograft reinforcement with a Valsalva Gelweave Dacron tube (Terumo Cardiovascular Systems Inc, Ann Arbor, Mich).
  
  
  METHODS
  Since 1992, we have performed 322 Ross operations; 12 patients underwent a modified Ross procedure with the autograft included in a Valsalva Gelweave Dacron tube. The mean age of these patients was 29.7 +/- 10.8 years (range, 15.3-46.5 years). The mean aortic crossclamp time was 126 +/- 11 minutes (range, 110-142 minutes). The mean follow-up was 4 +/- 1.4 years (range 1.7-5.8 years).
  
  
  RESULTS
  No perioperative deaths were observed, and all patients are alive and doing well. No significant autograft regurgitation was recorded during follow-up. The mean diameters of the autograft annulus and the neosinus of Valsalva were 23.3 +/- 2.6 mm and 32.6 +/- 3.3 mm, respectively, at discharge, and 24.0 +/- 1.9 mm and 33.6 +/- 3.3 mm, respectively, at the last control (P = .32 and P = .08, respectively).
  
  
  CONCLUSIONS
  These results support that this technical modification of the Ross operation might be proposed for patients at risk of autograft dilatation when an inclusion technique is not feasible.
authors.affiliation: Centre Hospitalier Régional et Universitaire de Lille, Pôle de Chirugie Cardio-vasculaire, 59037 Lille, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Juthier
authors.forename: Carlo
authors.initials: C
authors.lastname: Banfi
authors.forename: André
authors.initials: A
authors.lastname: Vincentelli
authors.forename: Pierre-Vladimir
authors.initials: PV
authors.lastname: Ennezat
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Tourneau
authors.forename: Claire
authors.initials: C
authors.lastname: Pinçon
authors.forename: Alain
authors.initials: A
authors.lastname: Prat
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000637:transplantation*; D012086:Reoperation; D013997:Time Factors; D055815:Young Adult