title: Mechanism of autograft insufficiency after the Ross operation in children.
abstract: BACKGROUND
  It is unclear how autografts grow and dilate after the Ross operation in children. We analysed autograft growth and dilatation in children who underwent the Ross operation and examined the relationship of these factors to autograft failure.
  
  
  METHODS
  From our institutional database, we retrospectively identified 33 children who underwent the Ross operation without aortic root reinforcement (mean age 9.9 years) and had normal body measurements and echocardiographic data throughout follow-up.
  
  
  RESULTS
  Autograft insufficiency developed in 10 patients 5.1 years after the Ross operation. The average Z score at the development of autograft insufficiency was -0.1 (range from -2.0 to 6.1). The proportions of patients who remained free of autograft insufficiency at 5 and 10 years were 87.2% and 55.7%, respectively. A consistent trend in the time course of Z score was not found in any age group studied.
  
  
  CONCLUSIONS
  Autograft growth and dilation after the Ross operation varied widely among patients, and the incidence of autograft insufficiency was independent of annulus size.
authors.affiliation: Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium. gogomotto@livedoor.com
authors.forename: Motohiko
authors.initials: M
authors.lastname: Goda
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
authors.forename: Benedicte
authors.initials: B
authors.lastname: Eyskens
authors.forename: Ruth
authors.initials: R
authors.lastname: Heying
authors.forename: Bjorn
authors.initials: B
authors.lastname: Cools
authors.forename: Filip
authors.initials: F
authors.lastname: Rega
authors.forename: Bart
authors.initials: B
authors.lastname: Meyns
mesh_terms: D000293:Adolescent; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D064592:Autografts / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011664:Pulmonary Valve / Q000637:transplantation*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome