Aortopulmonary size discrepancy is not a contraindication to the pediatricRoss operation

Background. Modification of the aortic annulus or the ascending aorta, or b oth, may be required in pediatric patients undergoing the Ross operation. T he fate of these autografts remains uncertain. Methods. Retrospective review of 15 patients undergoing Ross operation with out aortic annular modification (group 1), 11 patients requiring annular re duction (group 2, n = 11), and 8 patients requiring annular enlargement (gr oup 3, n = 8). Autograft function and dimensions were evaluated by echocard iography. Results. Autograft insufficiency was less than or equal to mild in 33 patie nts and moderate in 1 patient. The annulus body surface area ratio increase d in group 1 from 19.7 +/- 5 to 20.3 +/- 5 mm/m(2) (p = 0.8). The average a nnular reduction in group 2 was 5 +/- 1.5 mm, and 10 of 11 patients require d reduction of the ascending aorta (mean 11 - 5 mm). The annulus body surfa ce area ratio increased from 18.6 +/- 7 to 20.5 +/- 9 mm/m(2) (p = 0.2). Th e mean augmentation in annulus diameter in group 3 was 6 +/- 4 mm; the annu lus body surface area ratio decreased from 23.7 +/- 14 to 20.3 +/- 8 mm/m(2 ) (p = 0.5). Conclusions. We continue to offer the Ross operation to pediatric patients even when aortic annular or ascending aortic size discrepancies mandate sur gical modifications. (C) 2001 by The Society of Thoracic Surgeons.