Long-Term Outcomes of Patients Undergoing the Ross Procedure
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Long-Term Outcomes of Patients Undergoing the Ross Procedure. / Aboud, Anas; Charitos, Efstratios I; Fujita, Buntaro; Stierle, Ulrich; Reil, Jan-Christian; Voth, Vladimir; Liebrich, Markus; Andreas, Martin; Holubec, Tomas; Bening, Constanze; Albert, Marc; Fila, Petr; Ondrasek, Jiri; Murin, Peter; Lange, Rüdiger; Reichenspurner, Hermann; Franke, Ulrich; Gorski, Armin; Moritz, Anton; Laufer, Günther; Hemmer, Wolfgang; Sievers, Hans-Hinrich; Ensminger, Stephan.
in: J AM COLL CARDIOL, Jahrgang 77, Nr. 11, 23.03.2021, S. 1412-1422.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Long-Term Outcomes of Patients Undergoing the Ross Procedure
AU - Aboud, Anas
AU - Charitos, Efstratios I
AU - Fujita, Buntaro
AU - Stierle, Ulrich
AU - Reil, Jan-Christian
AU - Voth, Vladimir
AU - Liebrich, Markus
AU - Andreas, Martin
AU - Holubec, Tomas
AU - Bening, Constanze
AU - Albert, Marc
AU - Fila, Petr
AU - Ondrasek, Jiri
AU - Murin, Peter
AU - Lange, Rüdiger
AU - Reichenspurner, Hermann
AU - Franke, Ulrich
AU - Gorski, Armin
AU - Moritz, Anton
AU - Laufer, Günther
AU - Hemmer, Wolfgang
AU - Sievers, Hans-Hinrich
AU - Ensminger, Stephan
N1 - Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2021/3/23
Y1 - 2021/3/23
N2 - BACKGROUND: Treatment of aortic-valve disease in young patients still poses challenges. The Ross procedure offers several potential advantages that may translate to improved long-term outcomes.OBJECTIVES: This study reports long-term outcomes after the Ross procedure.METHODS: Adult patients who were included in the Ross Registry between 1988 and 2018 were analyzed. Endpoints were overall survival, reintervention, and major adverse events at maximum follow-up. Multivariable regression analyses were performed to identify risk factors for survival and the need of Ross-related reintervention.RESULTS: There were 2,444 adult patients with a mean age of 44.1 ± 11.7 years identified. Early mortality was 1.0%. Estimated survival after 25 years was 75.8% and did not statistically differ from the general population (p = 0.189). The risk for autograft reintervention was 0.69% per patient-year and 0.62% per patient-year for right-ventricular outflow tract (RVOT) reintervention. Larger aortic annulus diameter (hazard ratio [HR]: 1.12/mm; 95% confidence interval [CI]: 1.05 to 1.19/mm; p < 0.001) and pre-operative presence of pure aortic insufficiency (HR: 1.74; 95% CI: 1.13 to 2.68; p = 0.01) were independent predictors for autograft reintervention, whereas the use of a biological valve (HR: 8.09; 95% CI: 5.01 to 13.08; p < 0.001) and patient age (HR: 0.97 per year; 95% CI: 0.96 to 0.99; p = 0.001) were independent predictors for RVOT reintervention. Major bleeding, valve thrombosis, permanent stroke, and endocarditis occurred with an incidence of 0.15% per patient-year, 0.07% per patient-year, 0.13%, and 0.36% per patient-year, respectively.CONCLUSIONS: The Ross procedure provides excellent survival over a follow-up period of up to 25 years. The rates of reintervention, anticoagulation-related morbidity, and endocarditis were very low. This procedure should therefore be considered as a very suitable treatment option in young patients suffering from aortic-valve disease. (Long-Term Follow-up After the Autograft Aortic Valve Procedure [Ross Operation]; NCT00708409).
AB - BACKGROUND: Treatment of aortic-valve disease in young patients still poses challenges. The Ross procedure offers several potential advantages that may translate to improved long-term outcomes.OBJECTIVES: This study reports long-term outcomes after the Ross procedure.METHODS: Adult patients who were included in the Ross Registry between 1988 and 2018 were analyzed. Endpoints were overall survival, reintervention, and major adverse events at maximum follow-up. Multivariable regression analyses were performed to identify risk factors for survival and the need of Ross-related reintervention.RESULTS: There were 2,444 adult patients with a mean age of 44.1 ± 11.7 years identified. Early mortality was 1.0%. Estimated survival after 25 years was 75.8% and did not statistically differ from the general population (p = 0.189). The risk for autograft reintervention was 0.69% per patient-year and 0.62% per patient-year for right-ventricular outflow tract (RVOT) reintervention. Larger aortic annulus diameter (hazard ratio [HR]: 1.12/mm; 95% confidence interval [CI]: 1.05 to 1.19/mm; p < 0.001) and pre-operative presence of pure aortic insufficiency (HR: 1.74; 95% CI: 1.13 to 2.68; p = 0.01) were independent predictors for autograft reintervention, whereas the use of a biological valve (HR: 8.09; 95% CI: 5.01 to 13.08; p < 0.001) and patient age (HR: 0.97 per year; 95% CI: 0.96 to 0.99; p = 0.001) were independent predictors for RVOT reintervention. Major bleeding, valve thrombosis, permanent stroke, and endocarditis occurred with an incidence of 0.15% per patient-year, 0.07% per patient-year, 0.13%, and 0.36% per patient-year, respectively.CONCLUSIONS: The Ross procedure provides excellent survival over a follow-up period of up to 25 years. The rates of reintervention, anticoagulation-related morbidity, and endocarditis were very low. This procedure should therefore be considered as a very suitable treatment option in young patients suffering from aortic-valve disease. (Long-Term Follow-up After the Autograft Aortic Valve Procedure [Ross Operation]; NCT00708409).
KW - Adult
KW - Aortic Valve/pathology
KW - Aortic Valve Disease/diagnosis
KW - Echocardiography/methods
KW - Female
KW - Germany/epidemiology
KW - Heart Valve Prosthesis/adverse effects
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Humans
KW - Long Term Adverse Effects/diagnosis
KW - Male
KW - Postoperative Complications/diagnosis
KW - Prognosis
KW - Registries/statistics & numerical data
KW - Reoperation/classification
KW - Risk Assessment/methods
KW - Risk Factors
KW - Survival Analysis
KW - Transplantation, Autologous/adverse effects
KW - Treatment Outcome
U2 - 10.1016/j.jacc.2021.01.034
DO - 10.1016/j.jacc.2021.01.034
M3 - SCORING: Journal article
C2 - 33736823
VL - 77
SP - 1412
EP - 1422
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 11
ER -