Schusterova Ingrid, Tohatyova Alzbeta, Gaborova Gabriela and Drobnakova Simona
P. J. √?¬†af√?¬°rik University in Kosice, Slovakia
Posters & Accepted Abstracts: Primary Health Care
Replacement of the aortic valve or aortic root with a pulmonary autograft (Ross procedure) and replacement of the pulmonary valve with a pulmonary allograft or xenograft was first described in 1967 by Ross and is now a widely used technique for the treatment of aortic valve disease in the children and young adult. It provides a viable valve with potential advantages, including excellent hemodynamic function, ability to grow and durability with no need for anticoagulation. The registry of our institute has eight patients, five female and three male patients. The study period was from 2000 until today. The age of the patients ranges from 18 to 37 years old. All the patients in the childhood underwent the Ross procedure due to congenital aortic valve stenosis/regurgitation and all the operations were performed in a single center. In all cases the Ross operation was performed as an autograft root replacement without any reinforcement procedures. During the follow-up the patients had a physical examination approximately every 6 months and echocardiography once a year. The examinations were done by the local cardiologists with no experience with such patients, and sometimes not by the same cardiologist. The echocardiographic examinations were done according the guidelines of the American Society of Echocardiography. Cardiac CT (computer tomography) examination was done in the cases that the patient was referred to a redo surgery and due to limitations of the transthoracic echocardiography in one patient. The role of the preoperative CT was to determine the aortic diameter and to show the relationship between the sternum and the right ventricle. During the follow-up all the patients had a progressive dilation of the aorta with the diameter in the latest follow-up to range from 34 mm to 56 mm with also a progressive aortic regurgitation. Because of this, two patients were referred to a redo surgery and one patient had a sudden cardiac death. All the surviving patients are on NYHA class I-II. Concerning the medical treatment, all these were young patients with no hypertensive disease and they could not tolerate any beta blocker treatment.