Objective: To assess autograft, homograft and ventricular function, as well as exercise capacity, in adult patients who have undergone the Ross procedure.
Setting: Single centre paediatric and adult congenital heart disease unit.
Patients: 45 subjects (24.6y, range 16.9-52.2y) who underwent the Ross procedure between 1994 and 2006 (8.1y post Ross operation, range 2.0-14.0y).
Interventions: Cardiovascular magnetic resonance imaging, echocardiography and cardiopulmonary exercise testing.
Main outcome measures: Autograft and homograft stenosis, and regurgitation. Autograft size. Bi-ventricular function, scar volume and exercise capacity.
Results: Mean autograft regurgitation was 6.8±8.3% (trivial regurgitation) and diameter was 40.0±7.0mm. Mean homograft velocity was 2.4±0.6m/s (mild-moderate stenosis) and regurgitation was 6.1±8.3% (trivial regurgitation). Biventricular systolic function was normal (LV EF 63.1± 6.4% and RV EF 60.1± 7.6%). In 38% of cases there was evidence of LV scar, mostly noted within the inter-ventricular septum. The mean exercise capacity achieved was 87± 22% of predicted. There was no correlation between exercise capacity and ventricular function or scar.
Conclusion: This study demonstrates minor autograft and homograft dysfunction in the majority of patients post Ross procedure, associated with good ventricular function and exercise capacity. In addition, minor scar was present in a third of patients with no functional consequences.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.