Aortic root replacement with a pulmonary autograft in young adults: Medium-term results in 70 patients

Background. Pulmonary autograft aortic valve replacement has been introduce d in our institution in selected adult patients in light of the known disad vantages and limitations of conventional prosthetic valves. Methods. We prospectively evaluated the use of the pulmonary autograft in a series of 70 young adults (31.2 +/- 8.7 years, range 16 to 49 years) opera ted on from March 1992 to April 1997 with aortic root replacement only. Results. There were no in-hospital deaths and two noncardiac-related late d eaths during follow-up of up to 62 months (mean 33 months). Thromboembolic complications were not observed. One patient required reoperation for infec tive endocarditis 4.3 years after surgery. Discharge echo-Doppler studies s howed normal autograft and allograft valve function. Serial echo-Doppler st udies showed no significant progression of aortic insufficiency and no dila tation of the autograft. A severe stenosis of the pulmonary allograft devel oped in 1 patient. Conclusion. Aortic root replacement with a pulmonary autograft, although mo re complex than conventional prosthetic valve replacement, is a safe, effec tive, and reproducible procedure in properly selected adult patients. Long- term results remain to be evaluated. (C) 1998 by The Society of Thoracic Su rgeons.