AORTIC-VALVE REPLACEMENT WITH A PULMONARY AUTOGRAFT IN INFANTS WITH CRITICAL AORTIC-STENOSIS

Seven patients with critical aortic stenosis underwent aortic valve re placement with a pulmonary autograft (the Ross operation) between the ages of 5 weeks and 9 months. The operation was considered mandatory f or survival because of continued severe heart failure or valve avulsio n. Six of the patients had undergone unsuccessful previous palliations , such as commissurotomy, balloon dilation, and transventricular valvo tomy, performed singly (n = 1) or in combination (n = 5). The other pa tient with a severely hypoplastic aortic valve ring underwent the Ross procedure as a primary operation. Two operative deaths occurred, In b oth cases severe endocardial fibroelastosis was detected at autopsy. O ne late death 1 year after the operation resulted from progressive hyp ertrophic cardiomyopathy and pulmonary hypertension. The rest of the p atients are doing wet!, without medications. Apart from trivial regurg itation in two patients, the pulmonary autograft is performing well.