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The Ross operation in adolescents.

John W Brown1, Parth M Patel, Mark D Rodefeld

  • 1Department of Surgery, Division of Cardiothoracic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

World Journal for Pediatric & Congenital Heart Surgery
|December 12, 2013
PubMed
Summary
This summary is machine-generated.

The Ross aortic valve replacement (AVR) offers excellent long-term outcomes for adolescents, with a significantly lower incidence of late aortic stenosis compared to non-Ross AVR. Modified techniques improved reoperation rates, supporting its use in this age group.

Keywords:
Ross AVRaortic regurgitationdilated aortic rootteenager

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Pediatric Cardiology

Background:

  • The Ross aortic valve replacement (AVR) is standard for children, but its durability in older patients with aortic regurgitation and dilated aortic roots is debated.
  • This study reviews the Ross AVR experience in adolescents (10-20 years) at a single center, comparing outcomes to non-Ross AVR.

Purpose of the Study:

  • To evaluate the efficacy and safety of the Ross AVR in adolescents (10-20 years old).
  • To analyze mortality, complications, and reoperation rates, comparing Ross AVR to non-Ross AVR in this age group.

Main Methods:

  • A retrospective review of 79 patients (10-20 years) undergoing Ross AVR between 1993-2013, with a modified technique introduced in 2000.
  • Comparison with 26 age-matched patients undergoing non-Ross AVR during the same period.
  • Analysis included mortality, early/late complications, reoperation rates, and survival.

Main Results:

  • Early mortality was 0% for Ross AVR and 4% for non-Ross AVR. Late mortality was 2.5% for Ross AVR and 0% for non-Ross AVR.
  • Reoperation rates significantly decreased after modifying the Ross technique in 2000 (5.9% vs. 50% previously).
  • Ross AVR patients showed a significantly lower incidence of late aortic stenosis (0% vs. 53%) compared to non-Ross AVR.

Conclusions:

  • The Ross AVR is a suitable option for adolescents with a normal pulmonary valve, demonstrating excellent hemodynamic outcomes and reduced late aortic stenosis.
  • Modified Ross AVR techniques significantly improved reoperation rates, enhancing its long-term durability.
  • Long-term follow-up is crucial for all patients with aortic valve disease, irrespective of the surgical approach.