Partial left ventriculectomy in an infant with dilated cardiomyopathy

being living autogenous tissue. Hence the potential for growth exists when the pulmonary autograft is used in the aortic position, and that is the reason the Ross operation is considered ideal for aortic valve replacements in infants and children. However, the potential for growth is lost when the pulmonary autograft is used in the mitral position because it has to be housed within the Dacron tube. On the other hand, inasmuch as the autograft is lying in the left atrium as a top hat, a partial or total preservation of the mitral valve apparatus is feasible, as was done in our patient. The autograft is a living autogenous tissue, fully flexible, and it cannot obstruct the left ventricular outflow tract because of its position inside the left atrium (Figs I and 2). The improved clinical condition of our patient, freedom from anticoagulation, absence of thromboembolism, and the maintained excellent performance of the pulmonary autograft in the mitral position 6 years later cautiously support this procedure as a viable alternative in specific clinical situations requiring replacement of the mitral valve. However, a larger The Journal of Thoracic and Cardiovascular Surgery March 1999