PULMONARY AUTOGRAFT FOR AORTIC-VALVE REPL ACEMENT IN CHILDREN

The aortic stenosis represents 5% of all congenital cardiac pathology. The conventional treatments often do not give very satisfactory resul ts. Since 1990, as alternative to the traditional aortic valve replace ment, we used, in our institution, the Ross procedure (pulmonary autog raft). This consists in using the pulmonary valve as an autograft in a ortic position to replace the diseased valve. Then, the pulmonary outf low is reconstructed with a cryopreserved homograft. This study includ es 15 patients, aged between 16 months and 18 years, treated with this technique since 1990. There has been no mortality. All the patients a re alive at the follow-up, and all in NYHA functional class I. No reop eration has been necessary for valvular dysfunction. The post-operativ e doppler study at aortic level demonstrated those gradients: Mean + S D, 3.8 +/- 8.1 (range 0-23). No regurgitation haemodynamically importa nt has been recorded at aortic level nor in the pulmonary position. Po st-operative gradients at pulmonary level were : Mean + SD, 14.6 + 10. 6 (range 14-32).