Aortic root dilation after the Ross procedure

This study evaluated changes in neoaortic root geometry in patients who und erwent the pass procedure. Serial postoperative echocardiographic measureme nts of the neoaortic root indexed to the square root of body surface area ( centimeters divided by meters) were obtained from 30 patients (age range 3. 1 to 31.4 years) and compared with paired preoperative and immediate postop erative values. Normal aortic root diameter Z scores were derived from root dimensions obtained from 217 healthy controls. Compared with preoperative values, an immediate stretch of the neoaortic versus pulmonary root (annulu s and sinuses of valsalva) was observed at a mean follow-up period of 1 wee k. Additional aortic annular dilation from baseline prehospital discharge v alues was observed at 2 to 12 months (baseline vs follow-up annulus 7 score : 1.4 vs 2.6, p <0.01, n = 16) and at 16 to 33 months follow-up (0.8 vs 2.0 , p <0.05, n = 12). In a similar fashion, there wets additional enlargement of the aortic sinus from its stretched state at hospital discharge at 2 to 12 months (baseline vs follow-up sinus Z score: 2.0 vs 3.3, p <0.01, n = 1 7) and at 16 to 33 months (1.7 vs 3.0, p <0.01, n = 13). There were no diff erences in root size between 2 to 12 and 16 to 33 months after surgery. The re was a decrease in left ventricular size with no alteration in blood pres sure or degree of aortic valve regurgitation. Thus, aortic root dilation oc curs vp to the first year after the pass procedure but does not appear to p rogress beyond this time. (C) 1999 by Excerpta Medica, Inc.