Modified Rastelli using an autograft: A new concept for correction of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction (with an extension to other congenital heart defects)

2000 ◽  
Vol 3 (1) ◽  
pp. 117-124 ◽  
Author(s):  
Dominique Metras ◽  
Bernard Kreitmann
Keyword(s):  
Ventricular Septal Defect ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Septal Defect ◽  
Left Ventricular Outflow Tract ◽  
Heart Defects ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow

The role of Ross procedure in the management of congenital heart defects

2013 ◽  
Vol 154 (6) ◽  
pp. 219-224
Author(s):  
István Hartyánszky ◽  
András Kollár ◽  
Krisztina Kádár ◽  
László Ablonczy ◽  
Edit Novák ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Left Ventricular Outflow Tract ◽  
Heart Defects ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Left Ventricular Outflow

Introduction: The surgical strategy to manage multilevel left ventricular outflow tract diseases is changing constantly, however, the Ross-procedure has remained a standard method for 45 years. Aim: The aim of the study was to analyze early and mid-term results of Ross-procedure in congenital heart defects (single surgeon’s results). Methods: From 2001 until 2011 a total of 63 patients (age, 28 days–21 years; mean: 10 years, weight 3.4–96 kg; mean, 8.8 kg) underwent Ross (n = 40), Ross–Konno (n = 17) or Ross–Konno-mitral (n = 6) procedures. Indication for Ross procedure was aortic regurgitation in 15 patients (associated with ventricular septum defect in 8 patients) and a predominant aortic stenosis in 25 patients. 17 patients with severe left ventricular outflow tract obstruction underwent Ross–Konno procedure. 6 patients with concomitant mitral valve disease (Shone syndrome, 3 patients; complete atrioventricular septal defect, 3 patients) were reconstructed by Ross–Konno-mitral valve procedure. Results: Among Ross patients there were one early (cerebral complication) and one late death (homograft endocarditis) with a mean follow-up time of 7.4±1.8 years. Because of an early autograft endocarditis a 3-year-old boy underwent homograft implantation and was treated successfully with Bentall-procedure 9 years later. One patient with autograft regurgitation is waiting for reoperation. Among Ross–Konno patients there was no early or late death, and none of the patients underwent reoperation. In Ross–Konno-mitral patients there was one early death (28-day-old boy) and during a mean follow-up time of 2.5±1 years, and no reintervention or reoperation was needed in 5 patients. Conclusions: The results indicate a good outcome of Ross-, Ross–Konno-, Ross–Konno-mitral procedures in patients with congenital heart defects when surgery is performed by a highly experienced heart surgeon. In newborns, infants and small children Ross- and Ross–Konno procedures are the only methods for managing left ventricular outflow tract diseases. Concomitant severe mitral disease adds a high level of technical complexity to the Ross–Konno/mitral procedure, but it should be balanced against alternative strategies (eg. single ventricle palliation or transplantation). Orv. Hetil., 2013, 154, 219–224.

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