[HSF] (no subject)

[Hgrmd at aol.com]

Ani,
  As usual, your analysis of Ross results reflects my conclusions as  well.  
Unless they are scrupulously followed up, the results are probably  not quite 
as good as reflected in the literature.  At the last Society of  Heart Valve 
Disease, the Ross surgeon on your faculty gave a particularly  glowing account 
of his results.  I was skeptical then; I'm skeptical  now.  The major problem 
for me is that the Ross requires replacing a  usually normal root (This is the 
same criticism I have of stentless miniroots  for aortic stenosis.).  In 
addition, it converts single valve into double  valve disease.  
  Finally, the Ross is inherently more risky.  I know the surgeon  who did 
the Ross on my patient back in 1999.  This surgeon has and deserves  an 
excellent reputation.  However, I'll always remember how he asked me to  review a case 
in which he was being sued.  The patient was a 24 yo single  mother of 3 that 
he did a Ross for AI.  The patient died shortly after  surgery of a massive 
anteroseptal MI.  Though it was never proved, I'm sure  the fatality was due to 
injury of the 1st septal while harvesting the  autograft.  If the lady had 
just had a garden variety mechanical AVR, I'm  sure there would be 3 less 
orphans in my community.
 
Hal



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