Intermediate-Term Results of Medtronic Freestyle Valve for Right Ventricular Outflow Tract Reconstruction in the

Bursa Acibadem Hospital,Bursa, TurkeyThe long-term freedom from complications andreoperation associated with the Ross procedure hasmade this approach the modern choice for aortic valvereplacement (AVR) in children and adults with a longlife expectancy. The procedure is ideal for youngwomen with aortic valve disease who plan to bear chil-dren, and for those individuals who have contraindi-cations to anticoagulation. Changes in implantationtechniques transitioning from subcoronary to total rootreplacement and performing annular support has ledto a reduction in the incidence of pulmonary autograftregurgitation (1). Although the potential exists for animmune response with resultant pulmonary stenosisand possible early explantation of the pulmonaryhomograft, the overall results of the Ross procedurehave been excellent and highly reproducible (2).Despite the modern emphasis which is placed onorgan donation, replacement homografts for thedonated pulmonary valve remain relatively scarce.This lack of suitable alternatives for right ventricularoutflow tract (RVOT) reconstruction has severely lim-ited the wider application of the Ross procedure inmany parts of the world. Many alternatives such asvalveless conduits, stentless bioprostheses, syntheticvalved conduits and autologous repair techniques tohomograft replacement during the Ross procedurehave been reported during the past few years (3-8). Forexample, Konertz et al. (9) published the first pul-monary autograft series using Medtronic Freestylestentless bioprosthesis for RVOT in 1996.Unfortunately, in Turkey the difficulties encounteredin obtaining homograft valves has forced surgeons touse the same technique in order to offer the well-known advantages of the Ross procedure to youngpatients with aortic valve disease.