TRANSTHORACIC AND TRANSESOPHAGEAL ECHOCARDIOGRAPHIC STUDY OF PULMONARY AUTOGRAFT VALVE IN AORTIC POSITION

Eleven patients who underwent pulmonary valve autograft to aortic posi tion with placement of bovine pericardial prosthesis in pulmonary posi tion were studied with echocardiography. The etiology of aortic valvul oplasty as determined by anatomopathological examination was rheumatic in five, degenerative in four, and congenital in two. Important mitra l stenosis coexisted in two patients, and during the same operation as the Ross surgery, a mitral valvuloplasty with Carpentier ring was pra cticed on one and an open mitral commissurotomy on the other. Transtho racic echocardiography, which helped to confirm the viability of the s urgery by determining the diameters of the semilunar valve rings and q uantifying the severity of the aortic valve lesions, was performed on all patients before surgery and repeated 3 months later. Transesophage al echocardiograms were practiced on nine patients during the surgical procedure and repeated after 6 months on seven. The latter technique aided in immediate postoperative evaluation, and repetition at 6 month s served to explore the ventricular infundibuli and evaluate pulmonary valve performance in aortic position. In conclusion, transthoracic an d transesophageal echocardiography provide a practical and valuable me ans of investigating the pre-, trans- and postoperative conditions of patients undergoing Ross surgery.