40 Trends in Sinus of Valsalva Dilation After the Ross Procedure.

Abstract

Purpose: Since its original description in 1967 by Dr. Ross, the use of a pulmonary valve autograft for aortic valve replacement is becoming more prevalent. We analyzed pre and post operative data of pts who underwent the Ross procedure at Riley Children's Hospital in Indianapolis Indiana in order to follow trends of survival, reoperation, outflow valve integrity and aortic root dilation. This is a sub-analysis of nine patients who had multiple serial echocardiograms available for review. Methods: Clinical and echocardiographic data were reviewed on 81 consecutive children (n=66) and adults (n=14) that had a Ross procedure between 1993 and 2005. Median age at the time of the procedure was 13 years (range 9d to 36 years). A sub-analysis of nine patients who had serial echocardiograms available on our digital data base was performed using 2D measurements of the aortic annulus, sinus of valsalva and sino-tubular junction. The median age of these patients was 14 years (range 18mo-18 years). Follow up from surgery to the last echocardiogram was a median time of 4 years (range 650 days to 2302 days). Results: Almost 47% of patients developed dilation of the sinus of valsalva beyond the 95% of normal by late follow up (p 0.05). Conclusions: The Ross procedure is a good alternative to artificial valve replacement for aortic diseases, however dilation of the sinus of valsalva is common, but trends don't appear to exceed the rate of normal growth.