OP 71. Aortic Valve Replacement by Ross Procedure - Total Root Technique: Video Presentation
M. Cikirikcioglu, J. Jolou, K. Ahmadov, N. Poirie, S. El-Hamamsy
Chair(s): Roland Demaria, Mustafa Cikirikcioglu & Violetta Kékesi
8:50 - 9:00h
at Buda Room (B)
Categories: Cardiac and Vascular Surgery, Oral Session
Session: Oral Session VIII - Cardiac and Vascular Surgery II
Background
The Ross procedure(RP) is the replacement of the patient's pathological aortic valve (AV) with his own pulmonary valve (PV),and the replacement of the PV with a pulmonary homograft (PH). In this video presentation we describe a step-by-step approach of the Ross total root technique.
Material and Methods
A median sternotomy is performed. The aorta is cannulated in the aortic arch and bicaval cannulation is used. After cross-clamping and cardioplegia induction,a low transverse aortotomy is performed.
Result
PV autograft is harvested. The first septal artery is avoided by keeping the incision line 2mm below the attachment of the cusps. PH harvesting is completed by a transverse incision proximal to the PA bifurcation. After examining the PH, the infundibular muscle is trimmed down to 2mm below the insertion of the cusps in order to exclude the devascularised muscular part. Theautograft is then implanted as a total root using interrupted 4-0 prolene sutures.The coronary artery ostia are reimplanted using a running 6-0 prolene. The proximal and distal anastomosis of the PH are performed using a running 4-0 and 5-0 prolene respectively. The remaining PA is cut 2-3mm above the level of the sinotubular junction in order to reduce the risk of autograft dilatation by the systemic blood pressure.
Conclusion
The RP is a not complex operation, but it requires attention to several technical details which have a direct impact on short and long-term outcomes. These details can be learned through video presentations.
