HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Sami S. Kabbani Donald Ross Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kabbani, S. S. Articles by Ross, D. Search for Related Content PubMed PubMed Citation Articles by Kabbani, S. S. Articles by Ross, D. Related Collections Valve disease

Ann Thorac Surg 2004;78:60-65
© 2004 The Society of Thoracic Surgeons

---

Original article: cardiovascular

The mitral pulmonary autograft: assessment at midterm

^a Damascus University Cardiovascular Surgical Center, Damascus, Syria

Accepted for publication August 7, 2003.

^* Address reprint requests to Dr Kabbani, Damascus University Cardiovascular Surgical Center, Mezza St, PO Box 2837, Damascus, Syria
e-mail: dam-uncv{at}net.sy

Presented at the Video Session of the Fortieth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 26–28, 2004.

BACKGROUND: There is a dire need, especially in emergent societies, for a mitral substitute that does not require anticoagulation, and is not affected by early degeneration.

METHODS: Between 1997 and 2003, 80 patients had successful mitral valve replacement with a pulmonary autograft. Fifty-five patients were female, and the mean age was 39.3 years. Seventy-eight patients had rheumatic mitral disease and 2 congenital. The autograft was placed inside a rigid Dacron tubing for support, and the right ventricular outflow was reconstructed with a xenograft or a homograft. Recently we have used microwave energy to ablate atrial fibrillation when present.

RESULTS: Intraoperative transesophageal echocardiography revealed adequate mitral valve areas (mean area 2.76 cm²) and acceptable mitral gradients (mean 4.3 mm Hg) in all 80 patients. There was no mitral regurgitation or trace amounts in 61 patients, and mild regurgitation in 19. Operative mortality was 5.0%, and late mortality clearly related to the procedure 6.25%. Follow-up was complete except for 2 lost patients, with a mean of 25 months, and echocardiographic findings were generally stable during follow-up. One patient developed uncritical mitral stenosis and another uncritical stenosis and insufficiency during 4 to 5.5 years. Four more patients had progression of mitral regurgitation from "mild" to "moderate" over a period from 8 months to 3 years. Uncritical xenograft pulmonic stenosis developed in 2 patients. Most of the surviving patients (83%) remain in class I status.

CONCLUSIONS: We believe the pulmonary autograft is a good mitral substitute at the disposal of cardiac surgeons, especially when patients are young and when life anticoagulation is contraindicated or impractical.

This article has been cited by other articles:

				T. Gudbjartsson, T. Absi, and S. Aranki Mitral Valve Replacement Card. Surg. Adult, January 1, 2008; 3(2008): 1031 - 1068. [Full Text]

				S. Kabbani, H. Jamil, F. Nabhani, A. Hamoud, K. Katan, N. Sabbagh, A. Koudsi, L. Kabbani, and G. Hamed Analysis of 92 mitral pulmonary autograft replacement (Ross II) operations. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 902 - 908.e7. [Abstract] [Full Text] [PDF]

				J. W. Brown, M. Ruzmetov, M. D. Rodefeld, and M. W. Turrentine Mitral Valve Replacement With Ross II Technique: Initial Experience Ann. Thorac. Surg., February 1, 2006; 81(2): 502 - 508. [Abstract] [Full Text] [PDF]

				F. Filsoufi and D. H. Adams Invited commentary Ann. Thorac. Surg., July 1, 2004; 78(1): 65 - 66. [Full Text] [PDF]