Ross Aortic Valve Replacement Patients

This is a retrospective chart review examining our experience with the Ross procedure. There will be a treatment and control group. The treatment group will be children who have had the Ross procedure with the proximal buttressing technique. The control or comparisons group would be Ross procedure patients who did not receive the proximal buttressing technique. All children's charts reviewed will be of patients who had their surgery at Children's Healthcare of Atlanta between December 1994 and August 2003; only information available up until October 10, 2003 will be used for this study. We will review approximately 75 charts for this study.

The first aim of the study would be to examine basic information regarding bleeding incidence. The following information will be collected on both groups:

• Amount of chest tube bleeding within the first 24 hours, and
• Number of patients who required re-exploration for bleeding
• Time from cardiopulmonary bypass removal to time leaving the operating room (indicator of the need to "dry up").

The second aim of the study would be to review the echocardiograms on these patients. The pulmonary valve size before the Ross procedure would be measured on the preoperative transthoracic or transesophageal echocardiogram. This would then be compared with postoperative studies in the Operating Room by transesophageal echocardiography. The pre-discharge echocardiogram and follow-up echocardiograms (which are a routine for these patients and, therefore, would not be necessary to add to the study protocol) would be reviewed. Autograft root diameters would be measured. The diameters would be at the level of the valve leaflets, at the level of the commissures and at the sinotubular ridge. These would be compared against published Z values for these patients by age, weight and body surface area. At the same time, any degree of aortic insufficiency or left ventricular outflow tract obstruction would be noted and recorded. One non-invasive cardiologist will review all old echocardiograms.