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Prokaryotes can control gene expression through operons—DNA sequences consisting of regulatory elements and clustered, functionally related protein-coding genes. Operons use a single promoter sequence to initiate transcription of a gene cluster (i.e., a group of structural genes) into a single mRNA molecule. The terminator sequence ends transcription. An operator sequence, located between the promoter and structural genes, prohibits the operon’s transcriptional activity if bound by a repressor...
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Published on: May 19, 2022

Ross operation: 16-year experience.

Ronald C Elkins1, David M Thompson, Mary M Lane

  • 1Department of Surgery, Section of Thoracic and Cardiovascular Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla 73190, USA. ronald-elkins@ouhsc.edu

The Journal of Thoracic and Cardiovascular Surgery
|September 23, 2008
PubMed
Summary
This summary is machine-generated.

The Ross operation offers excellent survival rates for both adults and children. However, male sex and primary aortic insufficiency negatively impact long-term outcomes, increasing reoperation risk.

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Published on: April 1, 2022

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Pediatric Cardiac Surgery

Background:

  • The Ross operation is a complex aortic valve replacement procedure.
  • Understanding factors influencing its long-term success is crucial for patient selection and surgical technique optimization.

Purpose of the Study:

  • To identify surgical techniques and clinical parameters affecting outcomes in patients undergoing the Ross operation.
  • To evaluate the long-term efficacy and safety of the Ross operation.

Main Methods:

  • A prospective review of 487 patients undergoing the Ross operation between August 1986 and June 2002, with follow-up through August 2004.
  • Analysis included various surgical approaches: scalloped subcoronary implant, inclusion cylinder, root replacement, and root-Konno procedure.
  • Clinical and echocardiographic follow-ups were performed within two years of closure.

Main Results:

  • Actuarial survival was 82% ± 6% at 16 years, with a 3.9% hospital mortality.
  • Freedom from autograft failure was 74% ± 5%, significantly associated with male sex and primary aortic insufficiency.
  • Survival in children was 84% ± 8%, with 83% ± 6% freedom from autograft valve failure.

Conclusions:

  • The Ross operation demonstrates excellent survival in both adult and pediatric populations.
  • Male sex and primary aortic insufficiency are identified as negative predictors for late outcomes, necessitating careful consideration.
  • Patients should be counseled regarding the potential risk of reoperation associated with the Ross procedure.