PERIOPERATIVE CONDUCTION AND RHYTHM DISTURBANCES AFTER THE ROSS PROCEDURE IN YOUNG-PATIENTS

Background. The Ross procedure is performed for a variety of left vent ricular outflow tract diseases in children. The preoperative hemodynam ic burden of pressure or volume overload and associated ventricular hy pertrophy can predispose to ventricular arrhythmias. Additional proced ures performed with the Ross procedure (eg, Konno) may damage the cond uction system. Methods. Between January 1995 and February 1997, the Ro ss procedure was performed in 42 patients, 31 (74%) of whom had 71 pri or interventions. Concomitant procedures (n = 42 in 23 patients) inclu ded 17 annular-enlarging procedures. Screening was performed for perio perative conduction and rhythm abnormalities. Results. There was one p ostoperative death. Perioperative ventricular tachycardia occurred in 12 patients (29%), with 2 receiving antiarrhythmic medication for vent ricular tachycardia at discharge. Transient complete heart block occur red in 3 patients, all of whom had concomitant procedures performed in the subaortic area; all patients were discharged in sinus rhythm and no patient received a permanent pacemaker. Conclusions. The Ross proce dure can be performed successfully in children with complex cardiac di sease with low mortality and perioperative morbidity. The incidence of perioperative ventricular tachycardia is high (29%), suggesting the n eed for vigilant perioperative monitoring and long-term surveillance. (Ann Thorac Surg 1998;66:1383-8) (C) 1998 by The Society of Thoracic S urgeons