[HSF] Aortic Regurgitation in 16 year old

[ICHFNO at aol.com]

The child with aortic regurgitation I presented last week was operated on  
today. Leaflets were rolled and thickened severely, as with RF. Initially we did 
 3 leaflet thinning and leaflet augmentation with glutaraldehyde fixed 
autologous  pericardium. Gave the CP upon aortic closure and at low flow rate 
competency was  noted, but at high flows had some LV distention. Removed the clamp, 
and once the  heart was beating TEE showed moderate residual AI. Did a Ross. 
Made a  trileaflet valve from Goretex and remainder of pericardium for conduit. 
Off with  trivial AI and RV Valve conduit gradient of 5 by direct 
measurement. This is the  2nd one in a row we have had to convert to a Ross after failed 
leaflet  extension, must be doing something wrong!
 
Bill



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