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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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      1. Ozturk M, Tongut A, Hanabergh SS, et al. The Ross procedure with the inclusion technique. Operative Techniques in Thoracic and Cardiovascular Surgery, 2022 In Press.https://doi.org/10.1053/j.optechstcvs.2022.06.012

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      3. Konstantinov IE, Buratto E. Modified Root Inclusion Technique for the Ross Procedure in Children. Operative Techniques in Thoracic and Cardiovascular Surgery, 2022 In Press. https://doi.org/10.1053/j.optechstcvs.2022.07.001

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      Linked Article

      • The Ross and Ross-Konno Operation in Neonates and Infants
        Operative Techniques in Thoracic and Cardiovascular Surgery
        • 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
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        Open Access
      • Modified Root Inclusion Technique for the Ross Procedure in Children
        Operative Techniques in Thoracic and Cardiovascular Surgery
        • 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 Surgery
        • 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