Romanyuk O. The reconstruction of the right ventricular outflow tract in Ross operation

Dissertation is dedicated to the study of the problem of the right ventricular outflow tract (RVOT) creation in the Ross operation, elaboration and application of a new methods of pulmonary artery (PA) reconstruction. The advantages and disadvantages of the homagraft and autologous tissue use for creation of new pulmonary valve were determined on the base of analysis of early and late results of 50 operations of aortic valve replacement with pulmonary autograft (Ross operation). The proposed conception of "totally autologous" Ross operation has showed its effectiveness in the young aged group of patients (until 12 years). The documented growth ability of the pulmonary valve in the aortic position and the autologous tissue valve in the pulmonary position makes the "totally autologous" Ross procedure the operation of choice in patients with somatic growth. Analysis of the RVOT autologous tissue reconstruction evidences the right ventricle adaptation to functioning in the conditions of competent pulmonaryvalve absence in late follow up period. Absence of the hemodynamically apparent RVOT obstruction, minimal rate of reoperations due to the new PA function impairment and absence of clinically significant right ventricle disfunction in patients with autologous methods of reconstruction evidence the effectiveness of the autologous RVOT creation. Easiness of preparation and implantation, atrombogenity, low cost and availability permits the wide use of autologous tissues for the RVOT reconstruction in the Ross operation.