Key result
Autograft insufficiency developed in 30.3% of children after the Ross operation, with freedom from insufficiency at 5 and 10 years being 87.2% and 55.7%, independent of annulus size.
Why the study?
Does autograft growth and dilation correlate with the development of autograft insufficiency after the Ross operation in children?
Cohort (n=33)
No
Does autograft growth and dilation correlate with the development of autograft insufficiency after the Ross operation in children?
Autograft growth and dilation after the Ross operation in children vary widely, and the development of autograft insufficiency appears to be independent of annulus size.
Autograft insufficiency warrants long-term surveillance after pediatric Ross; leaves open the role of growth or dilation beyond annulus size.
BACKGROUND: It is unclear how autografts grow and dilate after the Ross operation in children. We analysed autograft growth and dilatation in children who underwent the Ross operation and examined the relationship of these factors to autograft failure. METHODS: From our institutional database, we retrospectively identified 33 children who underwent the Ross operation without aortic root reinforcement (mean age 9.9 years) and had normal body measurements and echocardiographic data throughout follow-up. RESULTS: Autograft insufficiency developed in 10 patients 5.1 years after the Ross operation. The average Z score at the development of autograft insufficiency was -0.1 (range from -2.0 to 6.1). The proportions of patients who remained free of autograft insufficiency at 5 and 10 years were 87.2% and 55.7%, respectively. A consistent trend in the time course of Z score was not found in any age group studied. CONCLUSIONS: Autograft growth and dilation after the Ross operation varied widely among patients, and the incidence of autograft insufficiency was independent of annulus size.
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Goda et al. (2012) conducted a cohort in children who underwent the Ross operation (n=33). Ross operation without aortic root reinforcement was evaluated on Autograft insufficiency. Autograft insufficiency developed in 30.3% of children after the Ross operation, with freedom from insufficiency at 5 and 10 years being 87.2% and 55.7%, independent of annulus size.
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