THE SPECIFICS OF THE INTERVENTION ON THE HEART WITH INFECTIOUS ENDOCARDITIS DURING ROSS C SURGERY IN A PATIENT

Highlights

The use of Ross surgery for endocarditis is most effective in IE, and in young patients with progressive pathology this is the preferred treatment method. After removal of the autograft, an unprecedented exposure of the exit tract of the left ventricle is achieved. Even in patients with very advanced pathology, the excretory tract of the left ventricle usually remains intact, which allows the autograft to be implanted in a standard way. For individual patients with simple endocarditis, Ross surgery is an attractive option for its usual advantages.

Aim. To evaluate the immediate results of the Ross procedure (using allografts and autografts) in patients with infective endocarditis.

Methods. The study included 17 patients with infective endocarditis of the aortic valve who underwent the Ross procedure. The mean age of patients was 34 ± 8.5 years (range 18–55 years). Patients over 35 years underwent preoperative coronary angiography. All patients underwent transthoracic echocardiography (TTE) before and after surgery, as well as intraoperative transesophageal echocardiography.

Results. Hospital mortality was 11.76% (2 cases) due to severe course of the disease with widespread valve damage and severe heart failure. Intraoperative echocardiography revealed no autograft insufficiency in any patient. No fatal outcomes were registered in the long-term period. During the follow-up period (3–56 months), one case of probable recurrent right-sided endocarditis was recorded in a patient with drug addiction. One patient underwent reoperation due to homograft stenosis.

Conclusion. The Ross procedure demonstrates high efficiency in treating infective endocarditis of the aortic valve, especially in young patients with progressive pathology. The technique provides optimal visualization of the left ventricular outflow tract after autograft removal. With preserved left ventricular outflow tract, standard autograft implantation is possible even in patients with severe pathological changes. In uncomplicated IE cases, the Ross procedure can be considered as the method of choice due to its advantages.

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