Autologous Pericardial Valved Conduit for the Ross Operation

Abstract

The feasibility and function of autologous pericardial valved conduit for right ventricular outflow tract reconstruction in the Ross operation were assessed. Between June 1997 and April 2002, 31 patients underwent this procedure at our institution; one was lost to follow-up. The other 26 males and 4 females were aged 17 to 60 years (mean, 36.6 years). Causes of aortic valve disease were infective endocarditis in 26 and rheumatic valve disease in 4. Mean follow-up was 16.7 months (range, 1-58 months). Preoperatively, 9 patients were in functional class II, 19 in class III, and 2 in class IV. Concomitant procedures included coronary artery bypass (1), mitral valve replacement (6), tricuspid valve replacement (1), and ventricular septal defect closure (1). Mean aortic crossclamp time was 199.4 min. There were 4 (13.3%) hospital deaths and no late death. Mean postoperative functional class was 1.17 with +0.36 aortic regurgitation, a peak gradient of 21.9 mm Hg (range, 6-59 mm Hg) across the conduit, and grade +0.96 pulmonary regurgitation. No conduit-related complication was detected. Use of autologous valved conduit for the Ross operation is feasible. Long-term follow-up is mandatory to assess durability.

Reconstruction of Trileaflet Pulmonary Valve Using Autologous Pericardium

“…The durability of these valves in the long term remains questionable however [8]. Several attempts have been made to construct a hand-fashioned autologous pericardial valved conduit intraoperatively [9][10][11][12][13][14]. All of them used some variation in suturing of the pericardial tissue to create a competent valve and conduit with limited long term success.…”

Autologous pericardial pulmonary conduit with single point attached commissures in a sheep model☆☆☆

“…Several attempts were made to construct a hand-fashioned autologous pericardial valved conduit intraoperatively [2,12,10,[22][23][24][25]. The methods were time-consuming and not always reliable.…”

Novel Use of Extracellular Matrix Graft for Creation of Pulmonary Valved Conduit

“…Among others, Chotivatanapong et al reported a technique using autologous pericardium to create a pulmonary valved conduit for the Ross operation. 9 Their technique involves a rather complicated and time-consuming process.…”