TY - JOUR
T1 - Neoaortic Root Diameters and Aortic Regurgitation in Children After the Ross Operation
AU - Hörer, Jürgen
AU - Hanke, Thorsten
AU - Stierle, Ulrich
AU - Takkenberg, Johanna J.M.
AU - Bogers, Ad J.J.C.
AU - Hemmer, Wolfgang
AU - Rein, Joachim G.
AU - Hetzer, Roland
AU - Hübler, Michael
AU - Robinson, Derek R.
AU - Sievers, Hans H.
AU - Lange, Rüdiger
PY - 2009/8
Y1 - 2009/8
N2 - Background: For children who require aortic valve replacement, the Ross operation provides a unique advantage of growth potential of the pulmonary autograft in the aortic position. This study assessed the progression of autograft root diameters and its effect on aortic regurgitation (AR). Methods: Neoaortic echo dimensions from 48 children (<16 years) undergoing Ross operation who had follow-up echocardiograms before age 20 were analyzed (mean follow-up, 5.1 ± 3.3 years). Results: The mean age at the time of the Ross operation was 10.0 ± 4.3 years. Mean z values of the neoaortic annulus (1.5 ± 0.4), sinus (2.5 ± 0.4), and sinotubular junction (2.6 ± 0.9) when the autograft was implanted were significantly larger compared with normal values (p < 0.001, all). The mean z values significantly increased with follow-up at the level of the sinus (0.5 ± 0.1/year, p < 0.001) and the sinotubular junction (0.7 ± 0.2, p < 0.001), but not at the level of the annulus (0.1 ± 0.1, p = 0.59). AR increased with follow-up time (0.07 ± 0.02 grade/year, p < 0.001). AR increased with sinotubular junction diameter (p = 0.028), but there was not significant evidence of an association with annulus diameter (p = 0.25) or sinus diameter (p = 0.40). Conclusions: Children undergoing Ross operation have larger neoaortic root dimensions than healthy children. Growth of the annulus matches somatic growth. The diameters of the sinus and the sinotubular junction increase significantly relative to somatic growth. The latter may explain the development of AR.
AB - Background: For children who require aortic valve replacement, the Ross operation provides a unique advantage of growth potential of the pulmonary autograft in the aortic position. This study assessed the progression of autograft root diameters and its effect on aortic regurgitation (AR). Methods: Neoaortic echo dimensions from 48 children (<16 years) undergoing Ross operation who had follow-up echocardiograms before age 20 were analyzed (mean follow-up, 5.1 ± 3.3 years). Results: The mean age at the time of the Ross operation was 10.0 ± 4.3 years. Mean z values of the neoaortic annulus (1.5 ± 0.4), sinus (2.5 ± 0.4), and sinotubular junction (2.6 ± 0.9) when the autograft was implanted were significantly larger compared with normal values (p < 0.001, all). The mean z values significantly increased with follow-up at the level of the sinus (0.5 ± 0.1/year, p < 0.001) and the sinotubular junction (0.7 ± 0.2, p < 0.001), but not at the level of the annulus (0.1 ± 0.1, p = 0.59). AR increased with follow-up time (0.07 ± 0.02 grade/year, p < 0.001). AR increased with sinotubular junction diameter (p = 0.028), but there was not significant evidence of an association with annulus diameter (p = 0.25) or sinus diameter (p = 0.40). Conclusions: Children undergoing Ross operation have larger neoaortic root dimensions than healthy children. Growth of the annulus matches somatic growth. The diameters of the sinus and the sinotubular junction increase significantly relative to somatic growth. The latter may explain the development of AR.
UR - http://www.scopus.com/inward/record.url?scp=67650726498&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2009.04.077
DO - 10.1016/j.athoracsur.2009.04.077
M3 - Journal articles
C2 - 19632419
AN - SCOPUS:67650726498
SN - 0003-4975
VL - 88
SP - 594
EP - 600
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 2
ER -