Replacement of Pulmonary Homograft

[Falcon1]

I am looking to hear from people who have had the Ross Procedure and then needed to have the Pulmonary Homograft replaced. What decision did you make and what was it like to go through a second operation.

Thanks,

Falcon1

 

[skimomck]

Welcome. This is a great place for support and lots of helpful information frmo people who have experienced similar heart valve problems. My son Teddy had a Ross 12/00 when he was 16 and is close to needing his pulmonary homograft replaced. When did you have your Ross and what problems are you experiencing?? Teddy's started with pulmonary stenosis problems after about 10 months but it stayed fairly stable until recently. His gradient was around 50 but now it is close to 70. They tried to balloon it this summer with mild success. They lowered his gradient from a peak of 80-100 to 70. His stenosis is at the conduit where the valve is attached not at the leaflets themselves. There are several others on this site with similar problems but it is not common. Good luck and I hope this info helps.
Cindy

 

[surfsparky]

Welcome to this great site!
Sorry to hear about needing your pulmonary homograft replaced- how long ago did you have your Ross procedure? I had my Ross done last year (I'm 33 years old), and I have stenosis on my pulmonary homograft that looks like a replacement may be needed in the future. I'm off to see the surgeon on the 29th of this month for tests, so I'll know more after that. What are your gradients? Any physical symptoms? Keep us posted,
Regards,

 

[Falcon1]

Pulmonary Valve

Pulmonary Valve

I had my surgery back in 1996. I feel good. I'm tired but I think that is because I put in a long day. The only real symptom I have is it's a little harder to workout like I used to. I don't run as much. More biking, eliptical machines and lighter weights. Other than that I live a normal life.

Falcon1

 

[chilihead]

I had my Ross done one year ago, on 11/18/2003. So far so good. I'd like to know what you learn about the pulmonary valve replacement. I do understand that it is a much easier surgery. Is there a minimally invasive option?

Regards,

Jim

 

[catwoman]

Jim:

Happy 1st anniversary!

 

[Hansolo]

Sure hope this thread stays active. I am in the situation of needing my pulmonary homograph replaced (could be a month or could be several). I noticed a lack of progress in my aerobic conditioning 6 months following my Ross procedure (June 2003 not 1993 as I put before) and then the slow deterioration of my condition over the past year. Each echo increasing the gradient. To me it is much more debilitating physically than my bicuspid aortic valve was but I am told that it is generally better tolerated, I guess from a mortality standpoint. I am now 38 yrs old and used to be quite active.

My problem appears to be the same as described by skimomck. There is tissue growth (muscle or scar) inferior to the annulus where the valve was sewn into the heart resulting in narrowing the outflow tract. I am beginning to think that this is not as rare as any other cause of early homograph failure. It is making my decision about another homograph vs. bioprosthetic (Carpenter-Edwards) difficult. On the one hand the homograph seems to be fine except this growth of tissue. If that is truly the case then the problem seems to be less related to the homograph and more related to the surgery. If the homograph is the primary problem then a bioprosthetic valve would seem the better choice because I cannot see another homograph doing better than the first. Problem is that they really won't know until they get in and look. That leads to the other problem that both options are not available at the same hospital at least not around me so I need to decide before they can get in and look.

The other concern I have is the lack of reports about using bioprosthetic valves in the pulmonary position. Has anyone any information on this? It seems that the practice is just to use a bioprosthetic that was designed for the AV in the PV and call it better because of the lower pressure but is that really the case for a bioprosthetic valve?

Please keep any info you have coming as this is very interesting that the weakest link in the Ross is homograph failure but homograph reops seem to get little reporting in terms of options and outcomes.

Cheers,

 

[surfsparky]

Hansolo,
sorry to hear about your homgraph, it's not quite the scenario you hope for after the Ross procedure, but unfortunately in a few cases, it seems to happen. I can't help you much in the area of homograph vs bioprosthetic. All I know is that when it comes time for mine to be replaced, the surgeon has said that he would like to use another homograph and possibly tissue match it this time. I'm not sure if this is the road I'll take, before then, I too, will have to do more research. At my last echo the gradients had not increased any further which I very relieved about. The surgeon however, said that he is not happy with my gradients as they are the highest in his case history, but he was glad too that the pressure gradients had not increased since the previous echo. Hopefully this means surgery is further in the distance!
Keep us posted with your research and any decisions you make,
Cheers,

 

[kurli]

Pulmonary homograft

Pulmonary homograft

Hello,
I dont really know what all of this means, all I know is that i had a pulmonary homograft because i was born with pulmonary stenosis & ASD. I got a homograft over a mechanical because I want to have kids one day.
I will need another valve replacement in about 10 years, this will probably be a mechanical valve.