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Ann Thorac Surg 2006;81:411-412
© 2006 The Society of Thoracic Surgeons

Editorial

Further Anatomical Insights Regarding the Ross Procedure

Robert H. Anderson, MD, FRCPath *

Cardiac Unit, Institute of Child Health, London, United Kingdom

* Address correspondence to Dr Anderson, Cardiac Unit, Institute of Child Health, 30 Guilford St, London, WC1N 1EH United Kingdom (Email: r.anderson@ich.ucl.ac.uk).

The first 20% of the full text of this article appears below.

As Horia Muresian [1] states in the opening sentence of the abstract to the work describing the structure and vascular supply of the arterial roots, "precise knowledge of anatomical details is of utmost importance in complex procedures such as the Ross operation." This study shows the relevant anatomy with exquisite clarity, and should be compulsory reading for all surgeons undertaking this operative maneuver [1]. It is more gratifying for me to study the beautiful preparations and interpretations, since as is stated in the opening section of the Results section, "a true annulus doesn't actually exist." As is also emphasized, my colleagues and I have been promulgating this concept for several years [2–4], yet whenever I attend surgical meetings, or joint cardiac conferences, I continue to hear descriptions of the "annuluses" of the aortic and pulmonary valves, yet I can never be sure of the structures being described. In reality, as Muresian [1] demonstrates so clearly by the meticulous dissections, which as emphasized are "planned and performed in order to expose the hidden details and intricate relations of the cardiac structures, particularly those of surgical and echographical significance," both the aortic and pulmonary roots extend between the basal ring and the sinutubular junction. The leaflets of the arterial valves are suspended within these roots in semilunar fashion (Fig 1), with the hinge lines crossing the anatomic ventriculo-arterial junction. This junction between the ventricle and the arterial root, a true anatomic ring, is best seen in the pulmonary root, where the valvar leaflets . . . [Full Text of this Article]


Related Article

The Ross Procedure: New Insights Into the Surgical Anatomy
Horia Muresian
Ann. Thorac. Surg. 2006 81: 495-501. [Abstract] [Full Text] [PDF]





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