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Published on: July 14, 2021
Ross procedure and left ventricular mass regression
Lennart F Duebener1, Ulrich Stierle, Armin Erasmi
1Department of Cardiac Surgery, University Hospital of Schleswig-Holstein, Campus Luebeck, Germany.
Circulation
|September 15, 2005
Summary
The Ross procedure effectively reduces left ventricular mass after aortic valve replacement. However, smoking and hypertension can hinder complete regression, highlighting the need for lifestyle management post-surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Left ventricular mass normalization is a key indicator of successful aortic valve replacement.
- The Ross procedure offers near-normal hemodynamics, facilitating studies on left ventricular reverse remodeling.
- Surgical technique, specifically subcoronary (SC) versus root replacement (RR), may impact left ventricular mass regression.
Purpose of the Study:
- To compare left ventricular mass regression after the Ross procedure using subcoronary versus root replacement techniques.
- To identify predictors of incomplete left ventricular mass regression following the Ross procedure.
Main Methods:
- Analysis of data from the German Ross Registry, including 646 patients who underwent the Ross procedure between 1990 and 2004.
- Preoperative and postoperative echocardiographic evaluations to assess left ventricular mass index (LVMI).
- Multivariate analysis to determine factors influencing LVMI regression at a mean follow-up of 3.5 years.
Main Results:
- Significant decrease in LVMI observed in both SC and RR groups post-procedure (P<0.01).
- LVMI regression plateaued by 1-year follow-up in most patients.
- High preoperative LVMI, smoking, and uncontrolled diastolic hypertension were predictors of incomplete LVMI regression.
Conclusions:
- The Ross procedure leads to favorable autograft hemodynamics and LVMI reduction at mid-term follow-up.
- Smoking cessation and management of arterial hypertension are crucial for optimizing postoperative outcomes and complete LVMI regression.
- These findings underscore the importance of lifestyle modifications in patients with corrected aortic valve disease, irrespective of age.
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