Dissection of a dilated autograft root

Abstract

Although the Ross procedure is still the preferred operation for aortic root replacement in children and young adults, the number of reoperations for autograft root dilatation after the Ross procedure has increased in recent years. In our ongoing prospective clinical and echocardiographic follow-up study of 146 consecutive patients undergoing a Ross procedure with the root replacement technique since 1988, 29 patients have undergone pulmonary autograft reoperations to date. In most cases valve cusps are intact, but because of progressive autograft root dilatation coaptation of the cusps is lost and aortic valve regurgitation occurs. We report a patient who presented with severe aortic regurgitation due to asymmetric autograft dilatation caused by a dissection in the noncoronary sinus of Valsalva.