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Congenital - Commentary| Volume 27, ISSUE 4, P447-448, December 2022

Commentary: Three techniques for providing “living” support of the autograft with the Ross operation in children to improve long-term outcome

  • Pedro J. del Nido
    Correspondence
    Address reprint requests to: Pedro J. del Nido, William E. Ladd Professor of Child Surgery, Harvard Medical School, Chief, Department of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115.
    Affiliations
    Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA
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      Late autograft dilation in the Ross procedure in children remains a risk. Three reports describe variations of the inclusion technique to mitigate this risk for different age groups and root sizes.
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      References

        • Ross DN.
        Replacement of aortic and mitral valves with a pulmonary autograft.
        Lancet. 1967; 2: 956-958
        • Barratt-Boyes BG
        Homograft aortic valve replacement in aortic incompetence and stenosis.
        Thorax. 1964; 19: 131-150
        • Stelzer P
        • Jones DJ
        • Elkins RC.
        Aortic root replacement with pulmonary autograft.
        Circulation. 1989; 80 (III-209-III-213)
        • Sievers HH
        • Hanke T
        • Stierle U
        • et al.
        A critical reappraisal of the Ross operation: renaissance of the subcoronary implantation technique?.
        Circulation. 2006; 114: I504-I511
        • Carrel T
        • Schwerzmann M
        • Eckstein F
        • et al.
        Preliminary results following reinforcement of the pulmonary autograft to prevent dilatation after the Ross procedure.
        J Thorac Cardiovasc Surg. 2008; 136: 472-475
        • Luciani GB
        • Casali G
        • Favaro A
        • et al.
        Fate of aortic root late after Ross operation.
        Circ. 2003; 108: II61-II67
        • Slater M
        • Shen I
        • Welke K
        • et al.
        Modification to the Ross procedure to prevent autograft dilatation.
        Semin Thorac Cardiovasc Surg Pediatric Card Surg Annu. 2005; : 181-184
        • Brown JW
        • Ruzmetov M
        • Shahriari AP
        • et al.
        Modification of the Ross aortic valve replacement to prevent late autograft dilation.
        Eur J Cardiothorac Surg. 2010; 37: 1002-1007
        • Sommerville J
        • Saravalli O
        • Ross D
        • et al.
        Long-term results of pulmonary autograft for aortic valve replacement.
        British Heart J. 1979; 42: 533-540
        • 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
        • Murin P
        • Weixler VHM
        • Moulla-Zeghouane J
        • et al.
        Subcotonary Ross/Ross-Konno operation in children and young adults: initial single centre experience.
        Eur L Cardiothorac Surg. 2021; 59: 226-233
        • Ruzmetov M
        • Welke KF
        • Geiss DM
        • et al.
        Failed autograft after the Ross procedure in children: Management and outcome.
        Ann Thorac Surg. 2014; 98: 112-118
        • Ozturk M
        • Tongut A
        • Hanabergh SS
        • et al.
        The Ross procedure with the inclusion technique.
        Op Tech Thorac Cardiovasc Surg. 2022; 27: 414-422
        • Winlaw DS
        • Greenberg JW
        • O'Donnell AP
        The Ross and Ross-Konno operation in neonates and infants.
        Op Tech Thorac Cardiovasc Surg. 2022; 27: 423-446
        • Konstantinov IE
        • Buratto E
        Modified root inclusion technique for the Ross procedure in children.
        Op Tech Thorac Cardiovasc Surg. 2022; 27: 405-413
        • Nelson JS
        • Pasquali SK
        • Pratt CN
        • et al.
        Ross procedure across the pediatric age spectrum.
        Ann Thorac Surg. 2015; 99: 2086-2095

      Linked Article

      • The Ross and Ross-Konno Operation in Neonates and Infants
        Operative Techniques in Thoracic and Cardiovascular SurgeryVol. 27Issue 4
        • Preview
          When replacement of the aortic valve in neonates and infants is required, the Ross-Konno procedure provides a high-quality left ventricular outflow with good mid-term durability. The procedural outcome is highly dependent on the pre-procedural condition of the neonate or infant. Most series contain substantial numbers of post-balloon valvotomy patients as emergent or urgent management of severe, acute regurgitation. In patients with compromised ventricular function, post-operative mechanical support may be required but is generally associated with a good outcome.
        • Full-Text
        • PDF
        Open Access
      • Modified Root Inclusion Technique for the Ross Procedure in Children
        Operative Techniques in Thoracic and Cardiovascular SurgeryVol. 27Issue 4
        • Preview
          Autograft stabilization has proven beneficial in adults but the same technique could not always be adopted in growing children undergoing the Ross procedure. The major concern regarding the longevity of autograft after the Ross operation in a growing child is the lack of means to stabilize the aortic root. Herein we described a modified root inclusion technique that achieves aortic root stabilization using autologous tissue.
        • Full-Text
        • PDF
      • The Ross Procedure With the Inclusion Technique
        Operative Techniques in Thoracic and Cardiovascular SurgeryVol. 27Issue 4
        • Preview
          The Ross procedure is superior as a valve substitute in children and early adulthood because of its clear survival benefits. The free standing-root implantation is associated with failure of the autograft and inclusion techniques that support externally the autograft warrants its longevity. The current technique consists in the implantation of the autograft within the native aortic root thereby both supporting the autograft and avoiding any coronary distortion.
        • Full-Text
        • PDF
        Open Access