Transthoracic and transesophageal echocardiographic study of pulmonary autograft valve in aortic position.

Eleven patients who underwent pulmonary valve autograft to aortic position with placement of bovine pericardial prosthesis in pulmonary position were studied with echocardiography. The etiology of aortic valvuloplasty as determined by anatomopathological examination was rheumatic in five, degenerative in four, and congenital in two. Important mitral stenosis coexisted in two patients, and during the same operation as the Ross surgery, a mitral valvuloplasty with Carpentier ring was practiced on one and an open mitral commissurotomy on the other. Transthoracic echocardiography, which helped to confirm the viability of the surgery by determining the diameters of the semilunar valve rings and quantifying the severity of the aortic valve lesions, was performed on all patients before surgery and repeated 3 months later. Transesophageal echocardiograms were practiced on nine patients during the surgical procedure and repeated after 6 months on seven. The latter technique aided in immediate postoperative evaluation, and repetition at 6 months served to explore the ventricular infundibuli and evaluate pulmonary valve performance in aortic position. In conclusion, transthoracic and transesophageal echocardiography provide a practical and valuable means of investigating the pre-, trans-, and postoperative conditions of patients undergoing Ross surgery.