[HSF] AI and ASC AO Aneurysm s/p Ross procedure

[psimha]

Someone experienced with the David procedure could probably do this 
(Daunting with extensive scarring is to be expected). The RVOT can be 
patched if there is stenosis.
Prasanna
Cysmd613 at aol.com wrote:
> I would like to get the Forum's opinions and advice concerning an interesting 
> patient referred to me.
>  
> 44 yo male who underwent Ross Procedure in 1995 (pulmonary homograft used to 
> replace PV and prox PA) for a 6cm ascending aortic aneurysm and bicuspid 
> aortic valve.  According to the op report, he did not have AI pre op.  
> Recently he has been having some dyspnea on exertion and decreased stamina 
> (he used to surf for 4 to 5 hours a day, now he can only last about 1.5 hours).  
> An echo showed moderate to severe AI, a 5.5 cm aortic root, and a significant 
> gradient across the pulmonic valve.
> Appears that he needs redo aortic root replacement and pulmonic valve 
> replacement.
> In your experience, how difficult is the dissection after a Ross procedure, 
> as I haven't had the pleasure of operating on a patient who has had a prior 
> Ross.  
> This patient does not wish a mechanical valve, so I would plan to use 
> pericardial valves.
>  
> Thank you in advance for your responses.
>  
> Carmi Stadlan
>
>
>
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