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Adult| Volume 27, ISSUE 2, P198-205, June 2022

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Autograft Stabilization for the Ross Procedure in Children

  • Edward Buratto
    Affiliations
    Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia

    Department of Paediatrics, University of Melbourne, Melbourne, Australia

    Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia
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  • Peter D. Skillington
    Affiliations
    The Royal Melbourne Hospital, Melbourne, Australia
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  • Igor E. Konstantinov
    Correspondence
    Address reprint requests to Igor E. Konstantinov, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Australia.
    Affiliations
    Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia

    Department of Paediatrics, University of Melbourne, Melbourne, Australia

    Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia

    Melbourne Children's Centre for Cardiovascular Genomics and Regenerative Medicine, Melbourne, Australia
    Search for articles by this author
      Aortic valve disease in children presents a considerable surgical challenge. When repair is not feasible, the Ross procedure represents the best option for replacement as it allows growth and does not require anticoagulation. However, there is a risk of progressive autograft dilatation, and eventual failure of the autograft with severe regurgitation. Autograft stabilization has proven beneficial in adults but has not been widely adopted in children undergoing the Ross procedure. We present a series of techniques for autograft stabilization which can be used at different stages of development, from infants to fully grown adolescents.

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      References

        • Buratto E
        • Konstantinov IE
        Aortic valve surgery in children.
        J Thorac Cardiovasc Surg. 2020; (in press)
        • Wallace FRO
        • Buratto E
        • Naimo PS
        • et al.
        Aortic valve repair in children without use of a patch.
        J Thorac Cardiovasc Surg. 2020;
        • Myers PO
        • Mokashi SA
        • Horgan E
        • et al.
        Outcomes after mechanical aortic valve replacement in children and young adults with congenital heart disease.
        J Thorac Cardiovasc Surg. 2019; 157: 329-340
        • Wiggins LM
        • Mimic B
        • Issitt R
        • et al.
        The utility of aortic valve leaflet reconstruction techniques in children and young adults.
        J Thorac Cardiovasc Surg. 2020; 159: 2369-2378
        • Baird CW
        • Sefton B
        • Chavez M
        • et al.
        Congenital aortic and truncal valve reconstruction utilizing the Ozaki Technique: short –term clinical results.
        J Thorac Cardiovasc Surg. 2021; 161: 1567-1577
        • Donald JS
        • Wallace FRO
        • Naimo PS
        • et al.
        Ross operation in children: 23-year experience from a single institution.
        Ann Thorac Surg. 2020; 109: 1251-1259
        • Tan Tanny SP
        • Yong MS
        • d'Udekem Y
        • et al.
        Ross procedure in children: 17-year experience at a single institution.
        J Am Heart Assoc. 2013; 2e000153
        • Sharabiani MT
        • Dorobantu DM
        • Mahani AS
        • et al.
        Aortic valve replacement and the ross operation in children and young adults.
        J Am Coll Cardiol. 2016; 67: 2858-2870
        • Luciani GB
        • Lucchese G
        • Carotti A
        • et al.
        Two decades of experience with the Ross operation in neonates, infants and children from the Italian Paediatric Ross Registry.
        Heart. 2014; 100: 1954-1959
        • Ivanov Y
        • Drury NE
        • Stickley J
        • et al.
        Strategies to minimise need for prosthetic aortic valve replacement in congenital aortic stenosis-value of the ross procedure.
        Semin Thorac Cardiovasc Surg. 2020; 32: 509-519
        • Bové T
        • Bradt N
        • Martens T
        • et al.
        The pulmonary autograft after the ross operation: results of 25-year follow-up in a pediatric cohort.
        Ann Thorac Surg. 2021; 111: 159-167
        • Charitos EI
        • Hanke T
        • Stierle U
        • et al.
        Autograft reinforcement to preserve autograft function after the ross procedure: a report from the german-dutch ross registry.
        Circulation. 2009; 120: S146-S154
        • Skillington PD
        • Mokhles MM
        • Takkenberg JJ
        • et al.
        The Ross procedure using autologous support of the pulmonary autograft: techniques and late results.
        J Thorac Cardiovasc Surg. 2015; 149: S46-S52
        • Skillington PD
        • Mokhles MM
        • Takkenberg JJ
        • et al.
        Twenty-year analysis of autologous support of the pulmonary autograft in the Ross procedure.
        Ann Thorac Surg. 2013; 96: 823-829
        • Juthier F
        • Banfi C
        • Vincentelli A
        • et al.
        Modified Ross operation with reinforcement of the pulmonary autograft: Six-year results.
        J Thorac Cardiovasc Surg. 2010; 139: 1420-1423
        • Buratto E
        • Shi WY
        • Wynne R
        • et al.
        Improved survival after the ross procedure compared with mechanical aortic valve replacement.
        J Am Coll Cardiol. 2018; 71: 1337-1344
        • Buratto E
        • Wallace FRO
        • Fricke TA
        • et al.
        Ross procedures in children with previous aortic valve surgery.
        J Am Coll Cardiol. 2020; 76: 1564-1573
        • Matalanis G.
        Valve sparing aortic root repairs–an anatomical approach.
        Heart Lung Circ. 2004; 13: S13-S18
        • Buratto E
        • Konstantinov IE.
        Valve-sparing aortic root surgery in children and adults with congenital heart disease.
        J Thorac Cardiovasc Surg. 2021; 162: 955-962
      1. Kirklin JW, Barratt-Boyes BG. Anatomy, dimensions, and terminology. In: Kirklin JW, Barratt-Boyes BG, editors. Cardiac surgery. 2nd ed. New York: Churchill Livingstone; 1993. p. 3- 60.

        • Rowlatt UF
        • Rimoldi HJA
        • Lev M.
        The quantitative anatomy of the normal child's heart.
        Pediatr Clin North Am. 1963; 10: 499-588
        • Konstantinov IE
        • d'Udekem Y
        • Brizard CP.
        Ross operation or aortic valve repair in neonates and infants?.
        J Thorac Cardiovasc Surg. 2014; 148: 362-363