Subcoronary Ross/Ross-Konno operation in children and young adults: initial single-centre experience

Area of Science:

• Pediatric Cardiac Surgery
• Aortic Valve Repair
• Congenital Heart Disease

Background:

• The Ross/Ross-Konno operation is a complex procedure for aortic valve disease.
• Modified techniques aim to improve outcomes in pediatric and young adult populations.
• Evaluating the long-term results of modified subcoronary Ross/Ross-Konno procedures is crucial.

Purpose of the Study:

• To assess the outcomes of the modified subcoronary Ross/Ross-Konno operation in pediatric and young adult patients.
• To analyze survival rates, morbidity, need for reintervention, aortic valve function, and aortic root dimensions.
• To identify specific risks and benefits in different age groups, particularly infants.

Main Methods:

• A retrospective analysis of 50 patients (median age 6.3 years) who underwent the modified subcoronary Ross/Ross-Konno operation between January 2013 and January 2019.
• Evaluation of survival, morbidity, reoperations, aortic valve function, and aortic root dimensions.
• Follow-up data analyzed for early and late outcomes, including reinterventions and valve function.

Main Results:

• Overall 5-year survival was 95%, with 1 early and 1 late death, both in the infant group.
• Freedom from reoperation on the autograft and RV-PA conduit at 5 years was 94% and 97%, respectively.
• 97% freedom from >mild aortic regurgitation at 5 years, with normal aortic root dimensions and excellent left ventricular function in most survivors.

Conclusions:

• The modified subcoronary Ross/Ross-Konno operation demonstrates excellent outcomes in children and young adults.
• Mortality and morbidity in infants undergoing this procedure remain significant.
• The technique is reproducible and offers advantages over prosthetic techniques that may impede somatic growth.