[HSF] Aortic Regurgitation in 16 year old

[psimha]

Are you doing individual cuspal extension (Mountain goes to Mohd) or are 
you using one long strip fixed at the ST junction in a triradiate 
fashion and that is sutured to the cusps (Mohd comes to the mountain). 
The latter is easier to do and ensures easier competence. It also 
ensures  a better coaptation area which is severely compromised in 
rheumatic aortic valves .
Muy worry is still wrt Ross in young rheumatics.
Prasanna
ICHFNO at aol.com wrote:
> 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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