[HSF] Aortic Regurgitation in 16 year old

[rwmfglycar at aol.com]

These cases are very pathology dependent. The thicker the leaflets the more the difficulty. I never was too happy with leaflet unfurling.
Pericardial leaflets in a goretex tube very interesting,

Bob


-----Original Message-----
From: ICHFNO at aol.com
To: OpenHeart-L at lists.hsforum.com
Sent: Mon, 12 Nov 2007 12:38 pm
Subject: [HSF] Aortic Regurgitation in 16 year old




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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