Seven-year outcome of pulmonary valve autograft replacement of the mitral valve in an infant

Kanzaki, Tomohito; Yamagishi, Masaaki; Yashima, Masafumi

doi:10.1016/j.jtcvs.2011.01.049

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…Pulmonary autografts represent the perfect matching tissue for valve replacement, typically used in the aortic (Ross procedure) or even the mitral position ( 55 ). Seven-year follow-up of the latter confirmed non-calcified leaflets.…”

Section: Immunogenicity and Phylogenetic Disparitymentioning

confidence: 99%

Residual Bioprosthetic Valve Immunogenicity: Forgotten, Not Lost

Human

Bezuidenhout

Aïkawa

et al. 2022

Front. Cardiovasc. Med.

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Despite early realization of the need to control inherent immunogenicity of bioprosthetic replacement heart valves and thereby mitigate the ensuing host response and its associated pathology, including dystrophic calcification, the problem remains unresolved to this day. Concerns over mechanical stiffness associated with prerequisite high cross-link density to effect abrogation of this response, together with the insinuated role of leaching glutaraldehyde monomer in subsequent dystrophic mineralization, have understandably introduced compromises. These have become so entrenched as a benchmark standard that residual immunogenicity of the extracellular matrix has seemingly been relegated to a very subordinate role. Instead, focus has shifted toward the removal of cellular compartment antigens renowned for their implication in the failure of vascularized organ xenotransplants. While decellularization certainly offers advantages, this review aims to refocus attention on the unresolved matter of the host response to the extracellular matrix. Furthermore, by implicating remnant immune and inflammatory processes to bioprosthetic valve pathology, including pannus overgrowth and mineralization, the validity of a preeminent focus on decellularization, in the context of inefficient antigen and possible residual microbial remnant removal, is questioned.

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Section: Immunogenicity and Phylogenetic Disparitymentioning

confidence: 99%

Residual Bioprosthetic Valve Immunogenicity: Forgotten, Not Lost

Human

Bezuidenhout

Aïkawa

et al. 2022

Front. Cardiovasc. Med.

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“…5,6 The literature regarding the Ross II procedure is largely composed of case reports or small case series providing limited follow-up. [7][8][9][10] The largest series for the Ross II procedure come from less developed countries, including Syria and India. A durable tissue valve that was cost-effective and did not require long-term anticoagulation was the leading impetus for their interest in the Ross II procedure.…”

Section: Commentmentioning

confidence: 99%

“…5,6 The literature regarding the Ross II procedure is largely composed of case reports or small case series providing limited follow-up. 7 -10…”

Section: Commentmentioning

confidence: 99%

Pulmonary Autograft Mitral Valve Replacement (Ross II): Long-Term Follow-Up of a US Center

Blitzer

Herrmann

Brown

2018

World J Pediatr Congenit Heart Surg

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Background: Mitral valve replacement (MVR) with a pulmonary autograft (Ross II) may be a useful technique for pediatric and young adult patients who wish to avoid anticoagulation. Our aim was to evaluate the long-term outcomes of the Ross II procedure at our institution. Methods: Patients undergoing the Ross II procedure between June 2002 and April 2008 were included. Preoperative diagnoses included rheumatic disease (n ¼ 5), congenital mitral valve (MV) pathology (partial atrioventricular canal defect [n ¼ 2], complete atrioventricular canal defect [n ¼ 1], Shone's complex [n ¼ 1]), and myocarditis (n ¼ 1). Results: Ten patients (eight females and two males) between 7 months and 46 years were included. Mean age at surgery was 25.2 + 15.7 years. There were no in-hospital deaths. Mean follow-up was 11.7 + 5.2 years. There were three late deaths at 11 months, 5 years, and 11 years, respectively. Causes of death included right heart failure, sepsis, and sudden cardiac arrest. Three patients required subsequent mechanical MVR a median of two years after the Ross II procedure (range: 1-4 years). There was no mortality with reoperation. Echocardiographic follow-up demonstrated mean MV gradients ranging from 2.2 to 9.6 mm Hg. Two patients had greater than mild MV regurgitation postoperatively, and all others had minimal mitral regurgitation or less. Two patients developed moderate MV stenosis. Conclusions: The Ross II procedure is an option for select older children and young adults desiring a durable tissue MVR to avoid long-term anticoagulation.

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