The Supported vs Unsupported Ross in Pediatric Patients: Neoaortic Root and Ventricular Function

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Thoracic Surgery

Background:

• The unsupported Ross procedure is associated with neoaortic root dilation.
• Limited data exists on the supported Ross procedure's efficacy in young patients.
• This study compares neoaortic root changes in adolescent patients undergoing supported versus unsupported Ross procedures.

Purpose of the Study:

• To compare the fate of the neoaortic root in adolescent patients who underwent supported versus unsupported Ross procedures.
• To assess the efficacy of the supported Ross procedure in mitigating neoaortic root dilation.
• To evaluate the long-term stability of the neoaortic root in pediatric patients.

Main Methods:

• Retrospective review of patients aged 10-18 who underwent Ross procedures between 1996-2019.
• Analysis of longitudinal echocardiographic changes in supported and unsupported Ross operations without Konno enlargement.
• Statistical analysis using regression and Mann-Whitney tests to account for follow-up time differences.

Main Results:

• Unsupported Ross patients showed significantly higher rates of change in aortic annulus and sinus diameters.
• No significant differences were observed in left ventricular internal diameter or aortic insufficiency rates.
• Median follow-up was 2.90 years for supported and 12.13 years for unsupported Ross.

Conclusions:

• The supported Ross procedure significantly mitigates progressive neoaortic root dilation, offering excellent stability.
• The supported Ross procedure is demonstrated to be safe and effective in adolescent patients.
• The supported Ross procedure may become increasingly important in managing pediatric aortic disease.