Successful aortic root replacement with pulmonary autograft in two infants

: Two infants with congenital aortic valve stenosis underwent successful aortic root replacement with pulmonary autograft. One of the patients was 9 months and weighted 4.2 kg, and the other was 10 weeks weighing 4.6 kg. The former had undergone balloon valvotomy with a resultant severe aortic regurgitation. Operative method was basically similar to that taught by Ross. In terms of the right ventricular outflow reconstruction, however, left atrial appendage was utilized as the posterior wall while equine pericardial monocusp patch formed the anterior wall in the former patient. In the latter, morphology of the left atrial appendage was not suitable for the same kind of reconstruction, and nonvalved equine pericardial tube was used. Both of the patients eventually gained satisfactory circulatory condition. Advantages of aortic root replacement with pulmonary autograft are good competence without residual stenosis, avoidance of anticoagulation, and the high potential of future growth. So this operation is especially indicated for neonates and infants with left ventricular outflow obstruction.