Results of the use of allograft and pulmonary autograft (Ross procedure) in active infective aortic valve endocarditis in children

Authors: M.I. Fedoseykina, D.A. Titov, D.V. Britikov, S.I. Babenko, R.M. Muratov

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

UDC: 616.132-089.843:616.126.52-007.1-089.844:616.126-002-022.7]-053.2
DOI: https://doi.org/10.24022/1810-0694-2019-20-11-12-986-995

Cite as: Fedoseykina M.I., Titov D.A., Britikov D.V., Babenko S.I., Muratov R.M. Results of the use of allograft and pulmonary autograft (Ross procedure) in active infective aortic valve endocarditis in children. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2019; 20 (11–12): 986–95 (in Russ.). DOI: 10.24022/ 1810-0694-2019-20-11-12-986-995

Received / Accepted: 25.06.2019/19.07.2019

Keywords: endocarditis Ross procedure autograft allograft aortic valve

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Abstract

Objective– to present the experience of surgical treatment active infective endocarditis in children using allograft and autograft in the aortic root position.

Material and methods. 11 patients underwent aortic allograft replacement, the Ross procedure was performed in 4 patients. The operation was repeated in 7 (47%) cases. Positive blood culture was obtained in 7 cases. 9 children had a small aortic root. All patients were admitted in the active stage of the disease, operations were performed according to vital indications.

Results. Early hospital mortality was 13%. Mean clinical follow-up was 15 years. There were no cases of thromboembolic or hemorrhagic events. Follow-up periods maximum instantaneous gradients after aortic valve allograft implantation 13.5 ± 3.7 mmHg. All had none or trivial regurgitation during the follow-up period. Freedom from reoperation in the pulmonary allograft at 15 years was 93,3%. Freedom from reoperation in the pulmonary autograft with root replacement 15 years was 100%. The freedom from infective endocarditis at 5 years was 100%, at 10 years was – 91%.

Conclusions. Decellularized valve allografts may be a promising alternative for a selected group of patients. Implantation for aortic root allograft or pulmonary autograft allows to solve the problem of a small aortic root, aortic root destruction and to reduce the risk of reinfection.

References

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About the authors

Mariya I. Fedoseykina, Postgraduate; orcid.org/0000-0003-4122-8565
Dmitriy A. Titov, Cand. Med. Sc., Researcher; orcid.org/0000-0002-0943-5727
Dmitriy V. Britikov, Dr. Med. Sc., Head of Group for Experimental Development of New Biological Materials for Cardiovascular Surgery
Svetlana I. Babenko, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0002-2621-4504
Ravil’ M. Muratov, Dr. Med. Sc., Professor, Head of Department of Emergency Surgery of Acquired Heart Defects; orcid.org/0000-0003-3321-9028

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Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

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