The Ross Procedure in Patients among the Pediatric Population, Post Ten Years of Experience

Anton A. Lukyanov*; Yuriy N.Gorbatyh, PhD,ScD; Alexander M. Karaskov, PhD,ScD; Alexander Yu. Omelchenko, PhD; Yuriy L. Naberuchin, PhD,ScD; Artyom V.Gorbatyh; Andrey A. Ivanov, PhD.

Academician E.N.Meshalkin Novosibirsk Research Institute of Circulation Pathology

*Corresponding author: Anton A. Lukyanov, Center for Pediatric Cardiac Surgery and Neonatal Surgery of the Academician E.N.Meshalkin Novosibirsk Research Institute of Circulation Pathology. 15 Rechkunovskaya str, Novosibirsk, 630055, Russia. E-mail: anthony1206@rambler.ru

Published: September 24, 2013

Abstract: 

The aim of the study was to analyze the results of the surgical treatment in pediatric patients who had undergone the Ross procedure.

Material and Methods: The study involved 114 patients between 12 days to 18 years in age. The early and late (up to 5 years) results of the treatment were studied. The examination included echocardiography, catheterization of the cardiac chambers and angiocardiography. The case distribution of patients based on diagnosis was as follows: isolated aortic valve stenosis (IAVS) in 38 (33.3%) patients, aortic valve insufficiency (AVI) in 33 (28.9%), and combined heart defects in 56 patients (49.1%).

Results: The death rate was 6.14% during the early postoperative period and 1.14% in the late postoperative period; the actuarial survival in the long-term was 98.86%. The complication rate was 51.5%. The most frequent complication was pericarditis (25.6%), whereas cardiac and respiratory failure occurred in 7.6% of the cases and cardiac arrhythmias in 6.1% of the cases. The average time spent in the intensive care unit was 3.48 ± 2.90 days; the hospitalization period on average was 24.70±10.87 days. After surgery, there was a tendency of the echocardiographic parameters to move toward normalization. The frequency of reoperation in the late period was 23.7%, the main reason for which being the conduit dysfunction in the position of the pulmonary artery (PA).

Conclusion: The clinical efficacy of the Ross procedure in the treatment of aortic valve malformations in the pediatric group was confirmed. However, in some cases, the need to perform repeated operations due to the increase in the ring size and an increase in the neo-aortic insufficiency during the somatic growth process.

Keywords: 
pediatric patients; heart defects; Ross procedure; homograft/xenograft.
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Int J Biomed. 2013; 3(3):161-165. © 2013 International Medical Research and Development Corporation. All rights reserved.