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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, Vol. 77, No. 11, 23.03.2021, p. 1412-1422.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Aboud, A, Charitos, EI, Fujita, B, Stierle, U, Reil, J-C, Voth, V, Liebrich, M, Andreas, M, Holubec, T, Bening, C, Albert, M, Fila, P, Ondrasek, J, Murin, P, Lange, R, Reichenspurner, H, Franke, U, Gorski, A, Moritz, A, Laufer, G, Hemmer, W, Sievers, H-H & Ensminger, S 2021, 'Long-Term Outcomes of Patients Undergoing the Ross Procedure', J AM COLL CARDIOL, vol. 77, no. 11, pp. 1412-1422. https://doi.org/10.1016/j.jacc.2021.01.034

APA

Aboud, A., Charitos, E. I., Fujita, B., Stierle, U., Reil, J-C., Voth, V., Liebrich, M., Andreas, M., Holubec, T., Bening, C., Albert, M., Fila, P., Ondrasek, J., Murin, P., Lange, R., Reichenspurner, H., Franke, U., Gorski, A., Moritz, A., ... Ensminger, S. (2021). Long-Term Outcomes of Patients Undergoing the Ross Procedure. J AM COLL CARDIOL, 77(11), 1412-1422. https://doi.org/10.1016/j.jacc.2021.01.034

Vancouver

Aboud A, Charitos EI, Fujita B, Stierle U, Reil J-C, Voth V et al. Long-Term Outcomes of Patients Undergoing the Ross Procedure. J AM COLL CARDIOL. 2021 Mar 23;77(11):1412-1422. https://doi.org/10.1016/j.jacc.2021.01.034

Bibtex

@article{0251b780c5214298884b3a830a7ad449,
title = "Long-Term Outcomes of Patients Undergoing the Ross Procedure",
abstract = "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).",
keywords = "Adult, Aortic Valve/pathology, Aortic Valve Disease/diagnosis, Echocardiography/methods, Female, Germany/epidemiology, Heart Valve Prosthesis/adverse effects, Heart Valve Prosthesis Implantation/adverse effects, Humans, Long Term Adverse Effects/diagnosis, Male, Postoperative Complications/diagnosis, Prognosis, Registries/statistics & numerical data, Reoperation/classification, Risk Assessment/methods, Risk Factors, Survival Analysis, Transplantation, Autologous/adverse effects, Treatment Outcome",
author = "Anas Aboud and Charitos, {Efstratios I} and Buntaro Fujita and Ulrich Stierle and Jan-Christian Reil and Vladimir Voth and Markus Liebrich and Martin Andreas and Tomas Holubec and Constanze Bening and Marc Albert and Petr Fila and Jiri Ondrasek and Peter Murin and R{\"u}diger Lange and Hermann Reichenspurner and Ulrich Franke and Armin Gorski and Anton Moritz and G{\"u}nther Laufer and Wolfgang Hemmer and Hans-Hinrich Sievers and Stephan Ensminger",
note = "Copyright {\textcopyright} 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2021",
month = mar,
day = "23",
doi = "10.1016/j.jacc.2021.01.034",
language = "English",
volume = "77",
pages = "1412--1422",
journal = "J AM COLL CARDIOL",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "11",

}

RIS

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 -