ROSS OPERATION USING A BOVINE BIOPROSTHETIC VALVE WITH AUTOLOGOUS PERICARDIAL CONDUIT IN THE PULMONARY POSITION

Between 1 February 1992 and 1 March 1993, we performed Ross's aortic r eplacement in 7 men and 4 women with rheumatic heart disease. The pati ents' ages ranged from 22 to 60 years (mean, 41 years). All 11 patient s had aortic valve disease; 2 also had mitral valve disease, In all pa tients, the right ventricular outflow tract was reconstructed using an autologous pericardial conduit containing a bovine cardiac valve biop rosthesis manufactured at our institution. The 2 patients who had mitr al valve disease underwent a concomitant mitral valvuloplasty. In 1 pa tient, minimal aortic regurgitation was documented by means of transes ophageal echocardiography immediately after the cessation of cardiopul monary bypass, but no hemodynamic compromise was noted. In another pat ient, mediastinal exploration was required for bleeding, 3.5 hours pos toperatively The follow-up period ranged from 6 to 16 months (mean, 11 .3 months). Results were assessed by means of clinical and transesopha geal echocardiographic studies. No infection or technical failure was encountered. No patient died. All patients remain asymptomatic, and fo llow-up echocardiography has revealed no transaortic or transpulmonary gradient. The Ross operation was chosen for this group of patients be cause it avoids the use of mechanical valves and subsequent anticoagul ant therapy Most of our patients have a low income and a history of no ncompliance with the strict postoperative drug regimen. Although the s hort-term results have been excellent with the Ross operation and our combination bioprosthesis, long-term evaluation is needed.