Treatment of congenital aortic valve stenosis: impact of the Ross operation.

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Serval ID
serval:BIB_0EF8E6908C60
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Treatment of congenital aortic valve stenosis: impact of the Ross operation.
Journal
Swiss Medical Weekly
Author(s)
Corno A.F., Goy J.J., Hurni M., Payot M., Sekarski N., von Segesser L.K.
ISSN
1424-7860
Publication state
Published
Issued date
2001
Peer-reviewed
Oui
Volume
131
Number
5-6
Pages
65-69
Language
english
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article - Publication Status: ppublish
Abstract
GOAL: To evaluate the impact of the Ross operation, recently (1997) introduced in our unit, for the treatment of patients with congenital aortic valve stenosis. METHODS: The period from January 1997 to December 2000 was compared with the previous 5 years (1992-96). Thirty-seven children (< 16 yrs) and 49 young adults (16-50 yrs) with congenital aortic valve stenosis underwent one of these treatments: percutaneous balloon dilatation (PBD), aortic valve commissurotomy, aortic valve replacement and the Ross operation. The Ross operation was performed in 16 patients, mean age 24.5 yrs (range 9-46 yrs) with a bicuspid stenotic aortic valve, 7/10 adults with calcifications, 2/10 adults with previous aortic valve commissurotomy, 4/6 children with aortic regurgitation following PBD, and 1/6 children who had had a previous aortic valve replacement with a prosthetic valve and aortic root enlargement. RESULTS: PBD was followed by death in two neonates (fibroelastosis); all other children survived PBD. Although there were no deaths, PBD in adults was recently abandoned, owing to unfavourable results. Aortic valve commissurotomy showed good results in children (no deaths). Aortic valve replacement, although associated with good results (no deaths), has been recently abandoned in children in favour of the Ross operation. Over a mean follow-up of 16 months (2-40 months) all patients are asymptomatic following Ross operation, with no echocardiographic evidence of aortic valve regurgitation in 10/16 patients and with trivial regurgitation in 6/16 patients. CONCLUSIONS: The approach now for children and young adults with congenital aortic valve stenosis should be as follows: (1) PBD is the first choice in neonates and infants; (2) Aortic valve commissurotomy is the first choice for children, neonates and infants after failed PBD; (3) The Ross operation is increasingly used in children after failed PBD and in young adults, even with a calcified aortic valve.
Keywords
Adolescent, Adult, Aortic Valve Stenosis, Child, Female, Humans, Male, Middle Aged, Pulmonary Valve, Reoperation, Retrospective Studies, Transplantation, Autologous, Treatment Outcome
Pubmed
Web of science
Create date
14/02/2008 14:17
Last modification date
04/10/2019 10:37
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