Right Ventricular Outflow Tract Replacement With Xenografts in Ross Patients Older Than 60 Years Alexander Karaskov, MD, Alexander Bogachev-Prokophiev,

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Right Ventricular Outflow Tract Replacement With Xenografts in Ross Patients Older Than 60 Years Alexander Karaskov, MD, Alexander Bogachev-Prokophiev, MD, Ravil Sharifulin, MD, Sergey Zheleznev, MD, Igor Demin, MD, Alexey Pivkin, MD, Irina Zhuravleva, MD The Annals of Thoracic Surgery Volume 101, Issue 6, Pages 2252-2259 (June 2016) DOI: 10.1016/j.athoracsur.2015.12.031 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Diepoxide-treated bovine pericardial xenograft. (A) Pattern of the xenograft. (B) Conduit external view. (C) Bench-test of the conduit (cross-sectional view). (D) Right ventricular outflow tract reconstruction with the xenograft during the Ross procedure. The Annals of Thoracic Surgery 2016 101, 2252-2259DOI: (10.1016/j.athoracsur.2015.12.031) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Survival after the Ross procedure. The Annals of Thoracic Surgery 2016 101, 2252-2259DOI: (10.1016/j.athoracsur.2015.12.031) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Dynamics of the pressure gradient between the right ventricle and pulmonary artery. Box plots depict median, interquartile range, and nonoutlier range. (p = comparison with the gradient at discharge; n = number of patients.) The Annals of Thoracic Surgery 2016 101, 2252-2259DOI: (10.1016/j.athoracsur.2015.12.031) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Correlation between graft size—25 mm (hatched bars), 27 mm (open bars), and 29 mm (solid bars)—and right ventricular outflow tract peak gradient. (r = Spearman’s correlation coefficient.) The Annals of Thoracic Surgery 2016 101, 2252-2259DOI: (10.1016/j.athoracsur.2015.12.031) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Computed tomography angiography 6 years after surgery. (A, B) Three-dimensional reconstruction of the xenograft. (С) Analysis of conduit calcification. The Annals of Thoracic Surgery 2016 101, 2252-2259DOI: (10.1016/j.athoracsur.2015.12.031) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Correlation between the right ventricular outflow tract (RVOT) gradient and Agatston score. (r = Spearman’s correlation coefficient.) The Annals of Thoracic Surgery 2016 101, 2252-2259DOI: (10.1016/j.athoracsur.2015.12.031) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions