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

Robinson, Derek, Bogers, Ad, Hanke, Thorsten, Hemmer, Wolfgang, Hetzer, Roland, Hörer, Jürgen, Hübler, Michael, Lange, Rüdiger, Robinson, Derek, Sievers, Hans, Stierle, Ulrich and Takkenberg, Johanna (2009) Neoartoc root diameters and aortic regurgitation in children after the Ross operation. Annals of Thoracic Surgery, 88. pp. 594-600. ISSN 0003-4975

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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.

Item Type: Article
Schools and Departments: School of Mathematical and Physical Sciences > Mathematics
Depositing User: Derek Robinson
Date Deposited: 06 Feb 2012 19:47
Last Modified: 09 Jul 2012 15:15
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