Related Experiment Video

Updated: Jul 25, 2025

A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position
11:20

A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position

Published on: April 1, 2022

3.1K

Paediatric aortic valve replacement: a meta-analysis and microsimulation study

Maximiliaan L Notenboom1, Art Schuermans2,3,4, Jonathan R G Etnel1

  • 1Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Erasmus MC, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Zuid-Holland, The Netherlands.

European Heart Journal
|June 27, 2023
PubMed

Insights

Paediatric aortic valve replacement (AVR) outcomes are suboptimal, with higher mortality in younger children. The Ross procedure offers a survival benefit over mechanical AVR (mAVR), but careful consideration of valve substitutes is crucial.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Biomedical Engineering

Background:

  • Paediatric aortic valve replacement (AVR) decision-making requires comprehensive outcome data.
  • Current outcomes for paediatric AVR are suboptimal, particularly for younger patients.

Approach:

  • A systematic review of 68 studies (5259 patients) published between 1990-2021 was conducted.
  • Data on early/late event rates and time-to-event for Ross, mechanical AVR (mAVR), homograft (hAVR), and bioprosthetic AVR were pooled.
  • Microsimulation modeling was used to estimate age-specific outcomes for different valve substitutes.

Key Points:

  • Pooled early mortality: Ross 3.7%, mAVR 7.0%, hAVR 10.6%.
  • Pooled late mortality rates/year: Ross 0.5%, mAVR 1.0%, hAVR 1.4%.
  • Microsimulation: 20-year reintervention risk was 42.0% for Ross vs. 17.8% for mAVR.

Conclusions:

  • The Ross procedure demonstrates a survival benefit compared to mAVR in paediatric patients.
  • All valve substitutes present considerable reintervention hazards.
  • Careful weighing of pros and cons of each valve substitute is essential for paediatric AVR selection.
Abstract

Keywords:
Aortic valveAortic valve replacementCongenital heart diseaseMicrosimulation

More Related Videos

Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model05:31

Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model

Published on: June 8, 2022

2.9K
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

11.4K

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
14
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
26