| Autor: |
Markham, Garrett H., Brown, John W., Wenos, Chelsea D., Jensen, Morten O., Jensen, Hanna K., Markham, Larry W., Herrmann, Jeremy L. |
| Zdroj: |
World Journal for Pediatric and Congenital Heart Surgery; November 2024, Vol. 15 Issue: 6 p801-805, 5p |
| Abstrakt: |
Background:Aortic valve disease results in left ventricular (LV) dilation and/or hypertrophy. Valve intervention may improve, but not normalize flow dynamics. We hypothesized that LV remodeling would be more favorable following the Ross procedure versus mechanical aortic valve replacement (mAVR). Methods:Patients who were 18 to 50 years of age and underwent Ross or mAVR from 2000 to 2016 at a single institution were retrospectively reviewed. Propensity score matching was performed and yielded 27 well-matched pairs. Demographics and echocardiographic variables of LV morphology and wall thickness were collected. Those with > mild residual valve disease were excluded. Primary endpoints included LV morphology. Ttest and Fisher exact test analysis were used for statistical comparison. Results:Average age at operation (Ross 35.3 ± 10.2 vs mAVR 37.3 ± 8.9 years) did not differ. Indication for operation was similar between groups. Preoperative echocardiographic variables did not differ. At average follow-up duration (Ross 7.9 ± 2.4 vs mAVR 7.3 ± 2.4 years), wall thickness was significantly smaller for Ross compared with mAVR (P= .00715). Only 4/27 (15%) of mAVR patients had normalized LV parameters compared with 16/27 (59%) of Ross patients (P= .000813). Residual hypertrophy was the most common long-term abnormality for mAVR. Conclusion:Following aortic valve replacement with the Ross procedure or mechanical aortic valve prosthesis, the Ross conferred more favorable LV remodeling compared with mAVR. Future directions include analyzing longer follow-up to determine if patterns persist and the impact on cardiac morbidity and mortality. |
| Databáze: |
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