More Than 25 Years of Experience With the Ross Procedure in Children: A Single-Center Experience
| Autor: | Christine Houde, Siamak Mohammadi, Frédéric Jacques, Philippe Chetaille, Christian Drolet, Jean-Marc Côté, Dimitri Kalavrouziotis, Laurence Vaujois, Charles Laurin, Elisabeth Martin, Jean Perron |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Percutaneous medicine.medical_treatment 030204 cardiovascular system & hematology Single Center 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Humans Medicine Autografts Child Survival rate Retrospective Studies Bioprosthesis Heart Valve Prosthesis Implantation business.industry Ross procedure Quebec Retrospective cohort study Mean age Aortic Valve Stenosis medicine.disease Cardiac surgery Surgery Survival Rate Treatment Outcome surgical procedures operative 030228 respiratory system Female Cardiology and Cardiovascular Medicine business Follow-Up Studies Forecasting |
| Zdroj: | The Annals of Thoracic Surgery. 110:638-644 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2019.10.093 |
| Popis: | Background Aortic valve replacement in children represents an important challenge. Concerns regarding pulmonary autograft and homograft longevity requiring reoperations are well recognized. Very long-term outcomes after the Ross procedure are still unknown. We reviewed our experience with the Ross procedure, aiming to define very long-term survival rate and freedom from reintervention. Methods This was a single-center retrospective cohort including 63 consecutive children who underwent the Ross procedure. Median follow-up duration was 20.5 years. Time-related events were assessed using Kaplan-Meier estimator. Results There were 51 (81%) boys, mean age 10.1 ± 5.8 years. Isolated aortic stenosis was the most common diagnosis (n = 29, 46%) and 34 (54%) patients previously underwent cardiac surgery. There was 1 (1.6%) in-hospital death. Overall survival at 5, 15, and 25 years was 96.7%, 94.4%, and 94.4%, respectively. Freedom from any autograft-related reintervention was 98.1%, 86.4%, and 61.2% at 5, 15, and 25 years, respectively. Fifteen (24%) patients underwent autograft reoperations. Among them, 10 (67%) patients underwent valve-sparing autograft reoperation. Freedom from any pulmonary conduit reintervention was 93.2%, 58.2%, and 28.3% at 5, 15, and 25 years, respectively. Thirty (46.6%) patients underwent conduit reintervention (8 percutaneous, 22 surgical replacements). Conclusions The pediatric Ross procedure is associated with excellent long-term survival. Ross-related reinterventions are more than twice as common on the pulmonary homograft than on the autograft. |
| Databáze: | OpenAIRE |
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