Document Detail


Ross operation in the adult: long-term outcomes after root replacement and inclusion techniques.
MedLine Citation:
PMID:  19101277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dilatation of the pulmonary autograft is a major concern after root replacement for the Ross operation. The inclusion technique would avoid this drawback, but few data are available on the long-term results of this technique. We retrospectively analyze long-term results of both techniques. METHODS: Of 218 patients undergoing the Ross operation between 1991 and 2006, 148 (68%) had root replacement and 70 (32%) underwent the inclusion technique. The mean age of the patients was 40 +/- 10 years (range, 16 to 64). Mean follow-up was 94 +/- 44 months (range, 13 to 196). Echocardiographic controls were available in 197 patients. Proximal aorta dilatation was defined as diameter > 40 mm. RESULTS: In the root and inclusion groups, 10-year overall survival was 94% +/- 4% and 97% +/- 4%, respectively. Freedom from autograft reoperation was 81% +/- 10% and 84% +/- 13%, respectively. Main cause of reoperation was autograft dilatation in the root group (13 of 16) and valve prolapse in the inclusion group (5 of 6). Freedom from proximal aorta dilatation was 57% +/- 12% and 80% +/- 15%, respectively. In the root group, dilatations (n = 48) affected systematically the autograft sinuses or sinotubular junction, whereas in the inclusion group, dilatations (n = 10) affected principally the ascending aorta (8 of 10). Freedom from severe autograft regurgitation was 86% +/- 9% and 83% +/- 13%, respectively. Root technique, follow-up length, and preoperative aortic valve regurgitation were predictors of proximal aorta dilatation. CONCLUSIONS: In the long term, both techniques showed excellent survival and similar rates of autograft failure. For root replacement, autograft dilatation was the main cause of failure. For the inclusion technique, the autograft, but not the ascending aorta, was protected against dilatation and autograft valve prolapse was the main cause of failure.
Authors:
Laurent de Kerchove; Jean Rubay; Agnès Pasquet; Alain Poncelet; Caroline Ovaert; Manuel Pirotte; Michel Buche; William D'Hoore; Philippe Noirhomme; Gebrine El Khoury
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  87     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-22     Completed Date:  2009-01-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  95-102     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic and Vascular Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium. laurent.dekerchove@uclouvain.be
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analysis of Variance
Aortic Valve / surgery*,  ultrasonography
Aortic Valve Insufficiency / mortality,  surgery,  ultrasonography
Aortic Valve Stenosis / mortality,  surgery,  ultrasonography
Cardiac Surgical Procedures / adverse effects,  methods*
Cohort Studies
Confidence Intervals
Dilatation, Pathologic / surgery,  ultrasonography
Echocardiography, Doppler
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Heart Valve Diseases / surgery*
Hemodynamics / physiology
Humans
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Pulmonary Valve / transplantation*
Reoperation
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Survival Analysis
Transplantation, Autologous / adverse effects
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Ann Thorac Surg. 2009 Jan;87(1):102   [PMID:  19101278 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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