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Outcome of 40 consecutive cases of modified Ross procedure using novel Dacron valved conduit

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective

The Ross procedure is an established option for aortic valve disease in children. Due to limited availability of pulmonary homograft, we devised a novel technique for right ventricular outflow tract (RVOT) reconstruction by preparing indigenous Dacron valved conduit.

Methods

Forty consecutive cases of modified Ross procedure done at our center (2013–2018) were analyzed. Thirty-seven patients (95%) were followed up with median duration of 2.5 (0.08–5.5) years. Median age was 12 (5–39) years. Nineteen (47.5%) patients had rheumatic aortic valve disease, while 19 (47.5%) had congenital aortic valve disease. Aortic root replacement with pulmonary autograft was performed in all patients. Dacron conduit for RVOT reconstruction was used with on table sewn bileaflet valve using Dacron patch (n = 22), expanded polytetrafluoroethylene (ePTFE) membrane (n = 10), bioprosthetic valve (n = 4), and pericardium (n = 4). Additional surgical procedures included mitral valve repair (n = 10), septal myectomy (n = 2), ascending aorta replacement (n = 1), ruptured sinus of valsalva (RSOV) repair (n = 1), and ventricular septal defect (VSD) closure (n = 1).

Results

There was one in-hospital mortality while one late death occurred at 3.5 years postoperatively. The neo-aortic valve regurgitation on echocardiographic evaluation at last follow-up was trivial (n = 28), mild (n = 7), and moderate (n = 2). Mild RVOT obstruction was present in 8 patients while 18 patients had mild pulmonary regurgitation. No patient required reintervention during follow-up.

Conclusion

Our early results of modified Ross procedure are encouraging, however, long-term follow-up is required.

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Authors and Affiliations

  1. Department of Cardiothoracic and Vascular Surgery, The Mission Hospital, Durgapur, West Bengal, 713212, India

    Lakshmi Kumari Sankhyan, Rajarshi Ghosh, Santosh Kumar, Sujoy Chatterjee, Satyajit Bose & Srirup Chatterjee

  2. Department of Pediatric Cardiology, The Mission Hospital, Durgapur, West Bengal, 713212, India

    Sudipta Bhattachariya, Saurabhi Das & Hemant Kumar Nayak

Authors
  1. Lakshmi Kumari Sankhyan
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  2. Rajarshi Ghosh
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Correspondence to Lakshmi Kumari Sankhyan.

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Conflict of interest

All authors declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent for the surgery was obtained from the parents or guardians in case the patient was a minor and from individual participant in case patient was a major. The study was a retrospective review of clinical data of patients who underwent Modified Ross procedure, and for this type of study, formal consent is not required.

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This work was supported by The Mission Hospital, Durgapur, West Bengal and received no specific grant from any funding agency,commercial, or not-for-profit sectors.

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Sankhyan, L.K., Ghosh, R., Kumar, S. et al. Outcome of 40 consecutive cases of modified Ross procedure using novel Dacron valved conduit. Indian J Thorac Cardiovasc Surg 36, 28–36 (2020). https://doi.org/10.1007/s12055-019-00845-8

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  • DOI: https://doi.org/10.1007/s12055-019-00845-8

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