Autograft Wrapping Reinforcement in Adolescents Undergoing Ross Operation: A Tailored Coat

<p>Dataset from Varrica A, Satriano A, Frigiola A, Giamberti A. Autograft Wrapping Reinforcement in Adolescents Undergoing Ross Operation: A&nbsp;Tailored Coat. Ann Thorac Surg. 2021 Jul 1:S0003-4975(21)01093-6. doi: 10.1016/j.athoracsur.2021.05.087. Epub ahead of print. PMID: 34217690.</p> <p>Abstract</p> <p><strong>Background:&nbsp;</strong>The Ross operation is a good surgical option for the pediatric population with aortic valve disease. However, the need for reoperation due to aortic root dilatation remains the principal limitation of this procedure. We report a small series of adolescents who underwent the Ross operation with Gore-Tex (W. L. Gore &amp; Associates, Flagstaff, AZ) membrane reinforcement to avoid the progressive dilatation of the neoaortic root.</p> <p><strong>Methods:&nbsp;</strong>Between March 2002 and March 2010, 15 adolescent patients underwent a modified Ross procedure with the autograft wrapping with 0.1-mm Gore Preclude (W. L. Gore &amp; Associates) pericardial membrane. Follow-up was performed by clinical and echocardiographic controls.</p> <p><strong>Results:&nbsp;</strong>These patients were a mean age of 15 &plusmn; 1.4 years. The mean aortic cross-clamp time was 130 &plusmn; 17 minutes. The mean cardiopulmonary bypass time was 187 &plusmn; 27 minutes. There was no hospital mortality. The mean follow-up was 15 &plusmn; 2.5 years (range, 9.7-17.7 years). During the follow-up, 1 patient required aortic valve reoperation for cusps prolapse. The mean diameters of annulus (22.8 &plusmn; 1.8 mm vs 23.3 &plusmn; 1.5 mm, P = .12), aortic root (27.4 &plusmn; 1.4 mm vs 28.2 &plusmn; 0.8 mm, P = .09), and sinotubular junction (24.3 &plusmn; 1.1 mm vs 25.1 &plusmn; 0.7 mm, P = .11) were not statistically different between discharge and follow-up.</p> <p><strong>Conclusions:&nbsp;</strong>The wrapping reinforcement autograft in the Ross procedure with Gore-Tex membrane is simple, safe, and does not require significant additional time. Our results showed good early and long-term outcomes for reoperation, aortic root dilatation, and aortic valve degeneration.</p>