Ross Procedure in Neonates and Infants: A European Multicenter Experience
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Ross Procedure in Neonates and Infants: A European Multicenter Experience. / Mookhoek, Aart; Charitos, Efstratios I; Hazekamp, Mark G; Bogers, Ad J J C; Hörer, Jürgen; Lange, Rüdiger; Hetzer, Roland; Sachweh, Joerg S; Riso, Arlindo; Stierle, Ulrich; Takkenberg, Johanna J M; Schoof, Paul H.
In: ANN THORAC SURG, Vol. 100, No. 6, 12.2015, p. 2278-2284.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Ross Procedure in Neonates and Infants: A European Multicenter Experience
AU - Mookhoek, Aart
AU - Charitos, Efstratios I
AU - Hazekamp, Mark G
AU - Bogers, Ad J J C
AU - Hörer, Jürgen
AU - Lange, Rüdiger
AU - Hetzer, Roland
AU - Sachweh, Joerg S
AU - Riso, Arlindo
AU - Stierle, Ulrich
AU - Takkenberg, Johanna J M
AU - Schoof, Paul H
N1 - Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2015/12
Y1 - 2015/12
N2 - BACKGROUND: Infants and neonates with severe left ventricular outflow tract obstruction may require pulmonary autograft replacement of the aortic root. In this retrospective multicenter cohort study, we present our experience with the Ross procedure in neonates and infants with a focus on midterm survival and pulmonary autograft durability.METHODS: A retrospective observational study was performed in 76 infants (aged less than 1 year) operated on in six congenital cardiac centers in The Netherlands and Germany between 1990 and 2013.RESULTS: Patients had a pulmonary autograft replacement of the aortic valve with (68%) or without (32%) septal myectomy. Median patient age was 85 days (range, 6 to 347). Early mortality (n = 13, 17%) was associated with neonatal age, preoperative use of intravenous inotropic drugs, and congenital aortic arch defects. Five patients (9%) died during follow-up. Freedom from autograft reintervention was 98% at 10 years. Echocardiography demonstrated good valve function, with no or trace regurgitation in 73% of patients. Freedom from right ventricular outflow tract reintervention was 51% at 10 years. Univariable analysis demonstrated superior freedom from reintervention of pulmonary homografts compared with aortic homografts or xenografts.CONCLUSIONS: Pulmonary autograft replacement of the aortic valve in neonates and infants is a high-risk operation but offers a durable neoaortic valve. Midterm durability reflects successful adaptation of the autograft to the systemic circulation. Late mortality associated with heart failure was an unexpected finding.
AB - BACKGROUND: Infants and neonates with severe left ventricular outflow tract obstruction may require pulmonary autograft replacement of the aortic root. In this retrospective multicenter cohort study, we present our experience with the Ross procedure in neonates and infants with a focus on midterm survival and pulmonary autograft durability.METHODS: A retrospective observational study was performed in 76 infants (aged less than 1 year) operated on in six congenital cardiac centers in The Netherlands and Germany between 1990 and 2013.RESULTS: Patients had a pulmonary autograft replacement of the aortic valve with (68%) or without (32%) septal myectomy. Median patient age was 85 days (range, 6 to 347). Early mortality (n = 13, 17%) was associated with neonatal age, preoperative use of intravenous inotropic drugs, and congenital aortic arch defects. Five patients (9%) died during follow-up. Freedom from autograft reintervention was 98% at 10 years. Echocardiography demonstrated good valve function, with no or trace regurgitation in 73% of patients. Freedom from right ventricular outflow tract reintervention was 51% at 10 years. Univariable analysis demonstrated superior freedom from reintervention of pulmonary homografts compared with aortic homografts or xenografts.CONCLUSIONS: Pulmonary autograft replacement of the aortic valve in neonates and infants is a high-risk operation but offers a durable neoaortic valve. Midterm durability reflects successful adaptation of the autograft to the systemic circulation. Late mortality associated with heart failure was an unexpected finding.
KW - Aortic Valve/abnormalities
KW - Autografts
KW - Cardiac Surgical Procedures/methods
KW - Echocardiography
KW - Female
KW - Follow-Up Studies
KW - Germany
KW - Heart Valve Prosthesis Implantation/methods
KW - Humans
KW - Infant, Newborn
KW - Male
KW - Netherlands
KW - Pulmonary Valve/transplantation
KW - Retrospective Studies
KW - Treatment Outcome
KW - Ventricular Outflow Obstruction/congenital
U2 - 10.1016/j.athoracsur.2015.08.008
DO - 10.1016/j.athoracsur.2015.08.008
M3 - SCORING: Journal article
C2 - 26603019
VL - 100
SP - 2278
EP - 2284
JO - ANN THORAC SURG
JF - ANN THORAC SURG
SN - 0003-4975
IS - 6
ER -
