Long-Term Clinical and Imaging Follow-Up After Reinforced Pulmonary Autograft Ross Procedure.

The Ross operation remains a controversially discussed procedure when performed in the full root technique because concern exists regarding late dilatation of the pulmonary autograft and regurgitation of the neo-aortic valve. In 2008, we published our short-term experience when using external reinforcement of the autograft, which was inserted into a prosthetic Dacron graft. This detail was thought to prevent neoaortic root dilatation. Since 2006, 22 adult patients have undergone a Ross procedure using this technique. Indications were aortic regurgitation (n = 2), aortic stenosis (n = 15), and combined aortic stenosis and insufficiency (n = 5). A bicuspid aortic valve was present in 10 patients. Prior balloon valvuloplasty had been performed in seven patients. No early or late deaths occurred in this small series. One patient required aortic valve replacement early postoperatively, but freedom from late reoperation is 100% in the 21 remaining patients. Echocardiography confirmed the absence of more than trivial aortic insufficiency in 15 patients after a mean of 70 months (range, 14 to 108 months). No autograft dilatation was observed during follow-up and all patients are in New York Heart Association Class I. Autograft reinforcement is a simple and reproducible technical adjunct that may be especially useful in situations known for late autograft dilatation, namely, bicuspid aortic valve, predominant aortic insufficiency, and ascending aortic enlargement. The mid- to long-term results are encouraging because no late aortic root enlargement has been observed and the autograft valve is well functioning in all cases.

Silicate and opal in the Ross Sea

Thirty-five box cores were collected from the continental shelf in the Ross Sea during cruises in January and February, 1983. Pb-210 and Pu-239, 240 geochronologies coupled with biogenic-silica measurements were used to calculate accumulation rates of biogenic silica. Sediment in the southern Ross Sea accumulates at rates ranging from <=0.6 to 2.7 mm/y, with the highest values occurring in the southwestern Ross Sea. Biogenic-silica content in surface sediments ranges from 2% (by weight) in Sulzberger Bay and the eastern Ross Sea to 41% in the southwestern Ross Sea. Biogenic-silica accumulation in the southwestern Ross Sea averages 2.7 * 10**-2 g/cm**2/y and is comparable to accumulation rates in high-productivity, upwelling environments from low-latitude continental margins (e.g., Gulf of California, coast of Peru). The total rate of biogenic-silica accumulation in the southern Ross Sea is approximately 0.2 * 10**14 g/y, with most of the accumulation occurring in basins (500-1000 m water depth). If biogenic-silica accumulation in the southern Ross Sea continental shelf is typical of other basins on the Antarctic continental shelf, as much as 1.2 * 10**14 g/y of silica could be accumulating in these deposits. Biogenic-silica accumulation on the Antarctic continental shelf may account for as much as a fourth of the dissolved silica supplied to the world ocean by rivers and hydrothermal vents.