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Neoartoc root diameters and aortic regurgitation in children after the Ross operation

journal contribution
posted on 2023-06-08, 00:03 authored by Derek Robinson, Ad Bogers, Thorsten Hanke, Wolfgang Hemmer, Roland Hetzer, Jürgen Hörer, Michael Hübler, Rüdiger Lange, Hans Sievers, Ulrich Stierle, Johanna Takkenberg
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.

History

Publication status

  • Published

Journal

Annals of Thoracic Surgery

ISSN

0003-4975

Publisher

Elsevier

Volume

88

Page range

594-600

Department affiliated with

  • Mathematics Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2012-02-06

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