Valve sparing aortic root replacement for dilatation of the pulmonary autograft and aortic regurgitation after the Ross procedure Toru Ishizaka, MD,

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Valve sparing aortic root replacement for dilatation of the pulmonary autograft and aortic regurgitation after the Ross procedure Toru Ishizaka, MD, Eric J Devaney, MD, Stephen R Ramsburgh, MD, Takaaki Suzuki, MD, Richard G Ohye, MD, Edward L Bove, MD The Annals of Thoracic Surgery Volume 75, Issue 5, Pages 1518-1522 (May 2003) DOI: 10.1016/S0003-4975(02)04904-4 Copyright © 2003 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Placement of the annular reduction suture using continuous horizontal mattress stitch of 2-0 Prolene (Ethicon, Somerville, NJ) suture. (B) The suture is tied over the calibrated dilator to fix the size of the annulus. The Annals of Thoracic Surgery 2003 75, 1518-1522DOI: (10.1016/S0003-4975(02)04904-4) Copyright © 2003 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) A separate piece of a scalloped graft was used for the reconstruction of each sinus to optimize exposure. (B) The coronary arteries are reimplanted and the same graft is interposed between the root and the ascending aorta. The Annals of Thoracic Surgery 2003 75, 1518-1522DOI: (10.1016/S0003-4975(02)04904-4) Copyright © 2003 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 A full-thickness section of resected pulmonary autograft in patient 2, showing diffuse fragmentation of elastic lamina and deposition of mucopolysaccharide (Movat stain, original magnification ×200). The Annals of Thoracic Surgery 2003 75, 1518-1522DOI: (10.1016/S0003-4975(02)04904-4) Copyright © 2003 The Society of Thoracic Surgeons Terms and Conditions