Lights and shadows on the Ross procedure: biological solutions for biological problems

Nappi, F., Spadaccio, C., Acar, C. and El-Hamamsy, I. (2020) Lights and shadows on the Ross procedure: biological solutions for biological problems. Seminars in Thoracic and Cardiovascular Surgery, 32(4), pp. 815-822. (doi: 10.1053/j.semtcvs.2020.04.006) (PMID:32439545)

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Abstract

The Ross procedure represents a valid option for aortic valve replacement in young adults and was repeatedly shown to restore survival to that of the age- and sex-matched general population. However, its major drawback relies in the risk of pulmonary autograft (PA) dilation, negative histological remodeling and need for reoperation. Several techniques and materials to reinforce the PA have been proposed. They mainly include Dacron, personalized external aortic root support with a polyethylene terephthalate mesh system, autologous aortic tissue and bioresorbable materials. Synthetic materials, despite widely used in cardiac surgery, have significant biocompatibility issues with the PA and their interaction with this living structure translates into negative remodeling phenomena and disadvantageous biomechanical behaviors. Conversely, biomaterials with tailored degradable profiles might be able to reinforce while integrating with the PA and enhance its remodeling capabilities. The recent advancement in this field are here discussed.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Spadaccio, Dr Cristiano
Authors: Nappi, F., Spadaccio, C., Acar, C., and El-Hamamsy, I.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Seminars in Thoracic and Cardiovascular Surgery
Publisher:Elsevier
ISSN:1043-0679
ISSN (Online):1532-9488
Published Online:19 May 2020

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