Gold in the dust: the re-evaluation of early surgical results of Ross procedure for aortic valve disease in children / 中华胸心血管外科杂志

ABSTRACT

Objective:To study the surgical results of Ross procedure in pediatric patients. We report our early outcomes of the Ross procedure for congenital aortic valve disease.Methods:Retrospective analysis was performed on all 16 children with congenital aortic valve disease that underwent a Ross procedure from May 2018 to December 2019. Three patients had aortic stenosis(AS), 5 had aortic regurgitation(AR), and 8 patients had AS/AR. Two patients had endocarditis. Nine patients had prior aortic valve surgeries or interventions, 7 had percutaneous balloon aortic valvuloplasty, 1 had surgical valvotomy and 1 had aortic valve repair by cusp extension. Six patients had bicuspid and 1 had quadricuspid aortic valves.Results:There was no early death. Mean CPB time was (193.8±66.9) min (range 123~359 min), mean aortic cross-clamping time was (125.9±29.7) (range 82-186 min). Mean ventilation time was (58.0±42.4) h (range 22.7-163.0 h), and mean ICU and hospital length of stay was (5.4±3.4) d (range 2-16 d) and (25.9±18.7) d (range 7-77d). Six patients developed low cardiac output syndrome and 2 patient had hepatic dysfunction, which all improved after treatment. Follow-up was complete in all patients from 3 to 23 months, and there was no late death. Thirteen patients were in NYHA grade Ⅰ, and 3 in grade Ⅱ. The peak gradients through the aortic valve and pulmonary valve were (8.3±5.5)mmHg (3.7-26.6mmHg) and (20.5±16.4) mmHg (6.8-62.1 mmHg), respectively. The aortic regurgitation was negative in 3 patients, trivial in 1 patient and mild in 12 patients. The pulmonary regurgitation was trivial in 4 patients, mild in 9 patients and moderate in 3 patients.Conclusion:Ross procedure is a safe, effective surgical operation for congenital aortic valve disease in children >1-year of age.