THE ROSS OPERATION - DO NATIVE AORTIC, NATIVE PULMONARY, AND HOMOGRAFT PULMONARY VALVE SIZE AND FORM DIFFERENCES INFLUENCE RESULTS

Background: The pulmonary autograft approaches the ideal aortic valve substitute but numerous technical modifications are debated. The valve s involved often differ in diameter and shape of the recipient annulus . We previously reported simplified surgical rules and early results o f 52 patients and here we extend the report to 76 patients and analyze the mid-term results with respect to valve mismatch. Methods: We stud ied the influence of geometric discrepancies. Valve regurgitation and gradient are compared for size discrepancies up to or more than 3 mm b etween recipient annulus and pulmonary autograft. The normal tricuspid recipient aortic annulus is compared with the flat circular redo-pros thetic or bicuspid annulus. Patients with plication of the aortic annu lus and remodeling of the distal aorta are reviewed, and lastly donor homograft to pulmonary autograft discrepancies up to and more than 3 m m are compared. Results: The results were comparable in all groups and no significant differences were observed. Conclusion: The pulmonary a utograft operation may be simplified, with good results at the least i n the first year despite operative tailoring due to valve discrepancie s.