Titre
Do surgical modifications at the annular level during the Ross procedure negatively influence the structural and functional durability of the autograft?
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Lögers, A.
Auteure/Auteur
Rosser, B.
Auteure/Auteur
Seifert, B.
Auteure/Auteur
Kretschmar, O.
Auteure/Auteur
Hübler, M.
Auteure/Auteur
Prêtre, R.
Auteure/Auteur
Ben Mime, L.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1569-9285
Statut éditorial
Publié
Date de publication
2018-11-01
Volume
27
Numéro
5
Première page
642
Dernière page/numéro d’article
649
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Do surgical modifications at the annular level (e.g. the modified Ross-Konno procedure or reduction plasty) influence the structure and function of the Ross autograft at the mid-term follow-up?
From June 2001 to July 2009, 49 patients (37 men and 12 women), mean age 10.5 ± 5.7 years (range 2 weeks to 17.8 years), underwent Ross operations. Twenty-one patients underwent additional aortic annulus reduction plasty and 9 patients a modified Ross-Konno procedure. The need for reintervention, reoperation and valve function were retrospectively analysed for a mean follow-up of 4.6 ± 2.7 years (range 9 days to 9.2 years).
There were no intraoperative or early death. Three late deaths occurred. Survival at 4 years was 91.9 ± 4.6%. In the overall cohort, aortic annular growth was 1 mm/year, corresponding to a z-score increase of 0.24/year (no mismatch group), 0.21/year (reduction plasty group) and 0.34/year (Ross-Konno group). At the last follow-up, sinotubular junction z-scores were 2.8 ± 1, 3 ± 1 and 2.4 ± 0.9 in the no mismatch, reduction plasty, and Ross-Konno groups, respectively. Ninety-three percent of patients presented with none-to-mild autograft valve regurgitation. The Ross-Konno group showed a significant increase in aortic annulus size (z-score of the annulus at the last follow-up 3.6 ± 1.6; P = 0.036). The no mismatch and the reduction plasty groups showed z-scores within the normal range (2.1 ± 1.7 and 2.5 ± 1.6, respectively).
Additional aortic annulus reduction or enlargement does not disturb the structural and functional durability of the autograft at the mid-term follow-up. Long-term autograft integrity, especially in the Ross-Konno group, remains to be investigated.
From June 2001 to July 2009, 49 patients (37 men and 12 women), mean age 10.5 ± 5.7 years (range 2 weeks to 17.8 years), underwent Ross operations. Twenty-one patients underwent additional aortic annulus reduction plasty and 9 patients a modified Ross-Konno procedure. The need for reintervention, reoperation and valve function were retrospectively analysed for a mean follow-up of 4.6 ± 2.7 years (range 9 days to 9.2 years).
There were no intraoperative or early death. Three late deaths occurred. Survival at 4 years was 91.9 ± 4.6%. In the overall cohort, aortic annular growth was 1 mm/year, corresponding to a z-score increase of 0.24/year (no mismatch group), 0.21/year (reduction plasty group) and 0.34/year (Ross-Konno group). At the last follow-up, sinotubular junction z-scores were 2.8 ± 1, 3 ± 1 and 2.4 ± 0.9 in the no mismatch, reduction plasty, and Ross-Konno groups, respectively. Ninety-three percent of patients presented with none-to-mild autograft valve regurgitation. The Ross-Konno group showed a significant increase in aortic annulus size (z-score of the annulus at the last follow-up 3.6 ± 1.6; P = 0.036). The no mismatch and the reduction plasty groups showed z-scores within the normal range (2.1 ± 1.7 and 2.5 ± 1.6, respectively).
Additional aortic annulus reduction or enlargement does not disturb the structural and functional durability of the autograft at the mid-term follow-up. Long-term autograft integrity, especially in the Ross-Konno group, remains to be investigated.
Sujets
PID Serval
serval:BIB_06CC0D69E914
PMID
Open Access
Oui
Date de création
2018-05-24T16:44:05.988Z
Date de création dans IRIS
2025-05-20T14:39:39Z