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Major Adverse Cardiac and Cerebrovascular Events After the Ross Procedure
- Source :
- Circulation, 122(11), S216-S223. Lippincott Williams & Wilkins
- Publication Year :
- 2010
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2010.
-
Abstract
- Background— The purpose of the study is to report major cardiac and cerebrovascular events after the Ross procedure in the large adult and pediatric population of the German-Dutch Ross registry. These data could provide an additional basis for discussions among physicians and a source of information for patients. Methods and Results— One thousand six hundred twenty patients (1420 adults; 1211 male; mean age, 39.2±16.2 years) underwent a Ross procedure between 1988 and 2008. Follow-up was performed on an annual basis (median, 6.2 years; 10 747 patient-years). Early and late mortality were 1.2% (n=19) and 3.6% (n=58; 0.54%/patient-year), respectively. Ninety-three patients underwent 99 reinterventions on the autograft (0.92%/patient-year); 78 reinterventions in 63 patients on the pulmonary conduit were performed (0.73%/patient-year). Freedom from autograft or pulmonary conduit reoperation was 98.2%, 95.1%, and 89% at 1, 5, and 10 years, respectively. Preoperative aortic regurgitation and the root replacement technique without surgical autograft reinforcement were associated with a greater hazard for autograft reoperation. Major internal or external bleeding occurred in 17 (0.15%/patient-year), and a total of 38 patients had composite end point of thrombosis, embolism, or bleeding (0.35%/patient-year). Late endocarditis with medical (n=16) or surgical treatment (n=29) was observed in 38 patients (0.38%/patient-year). Freedom from any valve-related event was 94.9% at 1 year, 90.7% at 5 years, and 82.5% at 10 years. Conclusions— Although longer follow-up of patients who undergo Ross operation is needed, the present series confirms that the autograft procedure is a valid option to treat aortic valve disease in selected patients. The nonreinforced full root technique and preoperative aortic regurgitation are predictors for autograft failure and warrant further consideration. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00708409.
- Subjects :
- Adult
Male
Aortic valve disease
medicine.medical_specialty
medicine.medical_treatment
Aortic Valve Insufficiency
Hemorrhage
Transplantation, Autologous
Postoperative Complications
Germany
Physiology (medical)
Humans
Medicine
Endocarditis
Registries
Netherlands
business.industry
Ross procedure
Mean age
Middle Aged
medicine.disease
Thrombosis
Surgery
Embolism
Aortic Valve
Female
Cardiology and Cardiovascular Medicine
Complication
business
Follow-Up Studies
Pediatric population
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 122
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....0e9e97cec3fb056ea89aa897ebbc8a63