Mid-Term Pulmonary Homograft Function for Right Ventricular Outflow Tract Reconstruction in the Ross Procedure

(Department of Cardiovascular Surgery, Jikei University School of Medicine, Tokyo, Japan)

Koji Nomura Hiromi Kurosawa Kiyozo Morita
Hirokuni Naganuma Katsushi Kinouchi
Fourteen patients (mean age 17.2 years, range 2 to 39 years) undergoing right ventricular outflow tract reconstruction for a Ross operation were studied between 1998 and 2000. Ten of 14 patients underwent Ross procedures and 4 received Ross-Konno procedures. Echocardiographic examination of the pulmonary homograft was performed after surgery. The mean follow-up period was 23.1 months, ranging from 14 to 33 months. Mean peak velocity and peak gradient were 1.6}0.4m/s and 11.9}5.2mmHg, respectively. Three patients in whom echocardiography revealed a peak pulmonary gradient of 20mmHg or more were retrospectively analyzed with each catheterization data. All patients had no more than 10mmHg at the distal end of the homograft with no evidence of deformity or shrinkage. Only one patient had a trivial homograft valve regurgitation, however, no patient had more than mild pulmonary regurgitation. Patient age, donor age, and preservation period did not reveal any significant risk factor for homograft stenosis. Pulmonary homograft appears to be an excellent substitute for right ventricular outflow tract reconstruction during the mid-term postoperative period.
@Jpn. J. Cardiovasc. Surg. 31F385-387 (2002)