Ross operation using a bovine bioprosthetic valve with autologous pericardial conduit in the pulmonary position


Por: Urrea M.S., Herrera V., Rey A., Vargas J.

Publicada: 1 ene 1993
Resumen:
Between 1 February 1992 and 1 March 1993, we performed Ross's aortic replacement in 7 men and 4 women with rheumatic heart disease. The patients' ages ranged from 22 to 60 years (mean, 41 years). All 11 patients had aortic valve disease; 2 also had mitral valve disease. In all patients, the right ventricular outflow tract was reconstructed using an autologous pericardial conduit containing a bovine cardiac valve bioprosthesis manufactured at our institution. The 2 patients who had mitral valve disease underwent a concomitant mitral valvuloplasty. In 1 patient, minimal aortic regurgitation was documented by means of transesophageal echocardiography immediately after the cessation of cardiopulmonary bypass, but no hemodynamic compromise was noted. In another patient, mediastinal exploration was required for bleeding, 3.5 hours postoperatively. The follow-up period ranged from 6 to 16 months (mean, 11.3 months). Results were assessed by means of clinical and transesophageal echocardiographic studies. No infection or technical failure was encountered. No patient died. All patients remain asymptomatic, and follow-up echocardiography has revealed no transaortic or transpulmonary gradient. The Ross operation was chosen for this group of patients because it avoids the use of mechanical valves and subsequent anticoagulant therapy. Most of our patients have a low income and a history of noncompliance with the strict postoperative drug regimen. Although the short-term results have been excellent with the Ross operation and our combination bioprosthesis, long-term evaluation is needed.

Filiaciones:
Urrea M.S.:
 Depto. de Cirugia Cardiovascular, Inst. Nac. Cardiol. 'Ignacio Chavez', Juan Badiano No 1, Mexico, D.F. 14080, Mexico

Herrera V.:
 Depto. de Cirugia Cardiovascular, Inst. Nac. Cardiol. 'Ignacio Chavez', Juan Badiano No 1, Mexico, D.F. 14080, Mexico

Rey A.:
 Depto. de Cirugia Cardiovascular, Inst. Nac. Cardiol. 'Ignacio Chavez', Juan Badiano No 1, Mexico, D.F. 14080, Mexico

Vargas J.:
 Depto. de Cirugia Cardiovascular, Inst. Nac. Cardiol. 'Ignacio Chavez', Juan Badiano No 1, Mexico, D.F. 14080, Mexico
ISSN: 07302347
Editorial
TEXAS HEART INST, PO BOX 20345, HOUSTON, TX 77225-0345 USA, Estados Unidos America
Tipo de documento: Article
Volumen: 20 Número: 4
Páginas: 271-274
WOS Id: A1993ML20700005
ID de PubMed: 8298323