Serial echocardiographic measurements of the pulmonary autograft in the aortic valve position after the ross operation in a pediatric population using normal pulmonary artery dimensions as the reference standard

• Published in: The American journal of cardiology Vol. 85; no. 9; pp. 1119 - 1123
• Main Authors: Solowiejczyk, David E, Bourlon, François, Apfel, Howard D, Hordof, Allan J, Hsu, Daphne T, Crabtree, Gregg, Galantowicz, Mark, Gersony, Welton M, Quaegebeur, Jan M
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2000; Elsevier
• Subjects: Adolescent; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; Biological and medical sciences; Body Surface Area; Cardiac Surgical Procedures; Cardiovascular system; Child; Child, Preschool; Dilatation, Pathologic; Female; Heart Valve Diseases - diagnostic imaging; Heart Valve Diseases - surgery; Humans; Infant; Infant, Newborn; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Pulmonary Artery - anatomy & histology; Pulmonary Artery - diagnostic imaging; Pulmonary Valve - diagnostic imaging; Pulmonary Valve - transplantation; Reference Values; Transplantation, Autologous; Ultrasonic investigative techniques; Ultrasonography; Sonography; Human; Echocardiography; Homograft; Exploration; Corporal biometry; Pulmonary valve; Pulmonary artery; Surgery; Graft; Aorta; Evolution; Child; Aortic valve
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(00)00707-4

Serial echocardiographic measurements of the annulus and sinus were obtained in children before the Ross operation, and early and late postoperatively. Values were compared with normal standards for the aorta and pulmonary artery (PA). There was no significant difference between PA annulus measurements before surgery and the corresponding autograft immediately afterward (1.73 ± 0.60 cm preoperatively; 1.63 ± 0.58 cm postoperatively, p = NS). Late after surgery the mean annulus diameter was enlarged compared with the normal aorta (ΔZ 1.9 ± 2.4), but remained relatively unchanged compared with the normal PA (ΔZ 0.7 ± 1.1, p <0.01). In contrast, the autograft sinus was dilated early after surgery (1.83 ± 0.58 cm preoperatively; 2.18 ± 0.73 cm postoperatively, p <0.01). Mean sinus Z score further increased compared with both the aorta (ΔZ 1.3 ± 1.7) and PA (ΔZ 1.3 ± 1.6). Use of standard PA measurements may be important in the assessment of autograft enlargement. Minimal change in autograft Z scores over time suggests that annulus enlargement is mainly due to somatic growth. In contrast, the autograft sinus showed an immediate and continued disproportionate increase in size over time, suggesting that sinus enlargement is largely due to passive dilation.