Outcome of Pulmonary Autograft After the Ross Procedure

2021 ◽  
Vol 12 (4) ◽  
pp. 508-515 ◽  
Author(s):  
Yuki Nakayama ◽  
Takeshi Shinkawa ◽  
Goki Matsumura ◽  
Ryogo Hoki ◽  
Kei Kobayashi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Hospital Discharge ◽  
Mechanical Valve ◽  
Good Health ◽  
Hospital Death ◽  
Ross Procedure ◽  
Prosthetic Aortic Valve ◽  
Related Risk ◽  
Combined Lesions

Background: The purpose of this study was to assess autograft function after the Ross procedure and to review surgical outcomes associated with autograft reoperations. Methods: This is a retrospective study of patients undergoing the Ross procedure since 1993. Autograft function and autograft reoperation were studied. Autograft failure was defined as more than moderate autograft regurgitation or autograft dilatation to more than 50 mm diameter or z-score of more than +4 in children. One hospital death was excluded from analysis as were patients with unknown late autograft status. Results: Among 75 patients analyzed, preoperative diagnosis before the Ross procedure included aortic regurgitation in 26, aortic stenosis in 19, combined lesions in 28, and 2 mechanical valve malfunctions. Median age at the Ross procedure was 12.1 (0.4-43.6) years with 44 children less than 15 years old. Six patients had greater than mild autograft regurgitation at post-Ross hospital discharge. During median follow-up of 14.9 years, there were 23 autograft failures. Eighteen autograft reoperations were performed on 17 patients (13 children), including 12 aortic valve replacements, 5 aortic root replacements (including 1 valve-sparing root replacement), and 1 Konno procedure. Freedom from autograft failure and autograft reoperation at 20 years after the Ross procedure was 52.0% and 66.3%, respectively. Multivariate analysis identified greater than mild autograft regurgitation at hospital discharge from Ross procedure as a risk factor for autograft failure ( P < .01). All patients who underwent autograft reoperation survived and had good health status at a median of 6.9 years after the reoperation. Conclusions: The Ross procedure is effective in delaying prosthetic aortic valve replacement, although the time-related risk of autograft failure is a real consideration.

scholarly journals Ross procedure and aortic valve repair: long-term echocardiographic outcomes, quality of life and physical activity of different aortic valve surgery procedures

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Bianco ◽  
M Colaneri ◽  
V Bucciarelli ◽  
FC Surace ◽  
FC Iezzi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Aortic Valve ◽  
Aortic Surgery ◽  
Ross Procedure ◽  
Valve Repair ◽  
Sf 36

Abstract Funding Acknowledgements Type of funding sources: None. Background  To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA). Methods  In 2005-19, 129 patients (median age 22 [13, 33 IQR], 75% males) underwent aortic surgery in our Department: 40 were Ross (22 years [19, 51 IQR]), 67 AVr (17 years [1, 50 IQR]) and 22 aortic valve replacements (52 years [30, 80 IQR]). We focused on Ross and AVr. Retrospectively, relevant data were collected from medical records and phone re-calls. Physical activity (spontaneous and active) and QoL were assessed utilizing the IPAQ and SF-36 questionnaires. All patients underwent echocardiography pre/post-surgery and the follow-up lasted 12 ± 4 years. Results  At the baseline, Ross patients had more aortic stenosis than insufficiency (P = 0.045). At the follow-up, Ross procedures presented more right-ventricle and aortic annulus dilatation (P = 0.002 and P = 0.030, respectively), but higher left-ventricular global longitudinal strain (LV GLS: 18 ± 3.2 % vs. 16 ± 3.3, P = 0.0027). Conversely, AVr experienced more re-do operations (Log-rank P = 0.005). Ross reported better QoL (SF-36: 0.8 ± 0.07 vs. 19 ± 0.4, P-0.045) and were also more active in daily PA (IPAQ ≥ 2500 Mets: 63.8% vs. 6%; P = 0.006). Ross patients practiced more sports activities than AVr (P = 0.011). Conclusions  In a relatively small cohort of young and adults post aortic surgery patients, Ross procedures had better prognosis in terms of re-do operations; presented better ventricular function, as assessed by LV GLS. Ross patients had better long-term QoL and showed more spontaneous PA and involvement in sports activity.

scholarly journals Characteristics and long-term outcomes of aortico-left ventricular tunnel

2020 ◽  
Author(s):  
Jing Sun ◽  
Hongxia Qi ◽  
Hongyuan Lin ◽  
Wenying Kang ◽  
Shoujun Li ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Surgical Repair ◽  
Mechanical Valve ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Aortic Orifice ◽  
The Right

Abstract OBJECTIVES Aortico-left ventricular tunnel (ALVT) is an extremely rare, abnormal paravalvular communication between the aorta and the left ventricle. Few studies have identified the characteristics and long-term prognosis associated with ALVT. METHODS The data of 31 patients with ALVT from July 2002 to December 2019 were reviewed. Echocardiography was performed in all patients during the follow-up period. RESULTS The median age of the patients was 11.5 years. Bicuspid aortic valve and dilatation of the ascending aorta were found in 13 patients, respectively. The aortic orifice in 20 patients showed a close relation to the right sinus and the right–left commissure. Of the 31 patients, 26 were operated on. Mechanical valve replacement was performed in 4 patients and aortic valve repair, in 6 patients. Ascending aortoplasty was performed in 5 patients and aortic replacement was done in 2 patients. One patient died of ventricular fibrillation before the operation. Follow-up of the remaining 30 patients ranged from 1 to 210 months (median 64 months). There were 4 deaths during the follow-up period: 1 had mechanical valve replacement and 3 did not undergo surgical repair. In the 26 patients without aortic valve replacement, 6 had severe regurgitation and 2 had moderate regurgitation. In the 28 patients without replacement of the ascending aorta, 11 had continued dilatation of the ascending aorta, including those who had aortoplasty. CONCLUSIONS The aortic orifice of ALVT showed an association with the right sinus and the right–left commissure. For patients who did not have surgery, the long-term survival rate remained terrible. Surgical closure should be done as soon as possible after ALVT is diagnosed. The main long-term complications after surgical repair included aortic regurgitation and ascending aortic dilatation.

scholarly journals Five-year echocardiographic follow-up after TAVI: structural and functional changes of a balloon-expandable prosthetic aortic valve

2017 ◽  
Vol 19 (4) ◽  
pp. 389-397 ◽  
Author(s):  
Manuela Muratori ◽  
Laura Fusini ◽  
Gloria Tamborini ◽  
Paola Gripari ◽  
Sarah Ghulam Ali ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Functional Changes ◽  
Prosthetic Aortic Valve

scholarly journals A 6-year experience of the Ross procedure in children with congenital aortic valve disease

2020 ◽  
Vol 48 (4) ◽  
pp. 240-245
Author(s):  
D. S. Akatov ◽  
V. A. Belov ◽  
D. E. Khomich ◽  
O. N. Bukhareva ◽  
A. A. Makarov ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Ross Procedure ◽  
Optimal Method ◽  
Advantages And Disadvantages ◽  
The Mean

Background: The choice of an optimal method for correction of aortic valve stenosis or insufficiency remains the matter of debate. Some clinicians prefer transluminal balloon angioplasty, some would perform an open type commissurotomy, or aortic valve replacement, or to valve leaflets repair with various materials, while others opt for the Ross procedure. Each of these techniques has its advantages and disadvantages both in the early postoperative period and in the long-term.Aim: To assess the results of the Ross procedure, its complications, survival, and probability of reoperations in the long-term.Materials and methods: We retrospectively analyzed the results of 32 Ross procedures performed from the end of 2012 to the beginning of 2019 in children aged from 3 days to 18 years. Eight children were below 1 year of age, including one newborn. A pulmonary autograft was placed into the aortic position in all children. In 31 children, a homograft was placed into the pulmonary artery. In one patient, an aortic autograft was implanted instead of the pulmonary artery valve. The mean patient age was 6.8 years, mean bodyweight 27.7 kg (range, 3.9–74.6 kg).Results: Two patients died in the early postoperative period (mortality 6.25%). We examined 26 patients at the follow-up, with its mean duration of 2.5 years. There were no indications for replacement of the homograft during the follow-up. One patient, in whom we had implanted an aortic autograft into the pulmonary position, required its replacement after 4.5 years. We have no data on death rates in the long-term.Conclusion: The Ross procedure provides satisfactory results in the early and intermediate postoperative period. Continuous follow-up is needed to determine the time points and the proportion of repeated interventions with a pulmonary homograft and aortic valve.

Outcomes of patients with acute prosthetic aortic valve endocarditis

2020 ◽  
pp. 021849232097411 ◽  
Author(s):  
Pietro Giorgio Malvindi ◽  
Carlo Olevano ◽  
Suvitesh Luthra ◽  
Geoffrey Tsang ◽  
Clifford Barlow ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Hospital Mortality ◽  
Medical Treatment ◽  
Prosthetic Valve Endocarditis ◽  
Early Death ◽  
Surgical Mortality ◽  
Mortality And Morbidity ◽  
Prosthetic Aortic Valve ◽  
Kaplan Meier

Background Prosthetic valve endocarditis is burdened by high mortality and morbidity. We reviewed our experience in the management of patients with acute prosthetic aortic valve infection and studied the implications and outcomes associated with surgical treatment and medical therapy. Methods Data of 118 consecutive patients admitted during the period 2008–2018 with definite acute prosthetic aortic valve endocarditis, and presenting a surgical indication, were retrieved from the hospital database. Univariate and multivariate analysis were undertaken to study the association of preoperative characteristics with hospital mortality and the probability of undergoing a reoperation. Survival was assessed with Kaplan-Meier analysis. Results In the overall population, prosthesis dehiscence was independently associated with the possibility of undergoing surgical reoperation, while presentation with embolic stroke was associated with medical treatment. Hospital mortality was 24%, medical treatment was found to be independently associated with early death. One hundred (85%) patients underwent redo procedures; aortic valve replacement was performed in 53 and full root replacement in 47. Postoperative hospital mortality was 17%. Survival at 1-, 5-, and 8-years was 78%, 74%, and 66%, respectively. Freedom from reoperation and recurrent endocarditis was 95% at 8-year follow-up. Hospital mortality in patients who did not receive a redo operation was 61% with a survival rate of 17% at 1-year follow-up. Conclusions Surgical mortality after reoperation for prosthetic aortic valve endocarditis is still high but mid-term outcomes are satisfactory. Failure to undertake surgery when indicated is an independent risk factor for early death.

scholarly journals Reconstruction of the aortic valve leaflet with autologous pulmonary artery wall

2020 ◽  
Vol 59 (1) ◽  
pp. 269-270
Author(s):  
Jean-Marc El Arid ◽  
Paul Neville ◽  
Nathalie Soulé ◽  
Bruno Lefort
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Young Patients ◽  
Valve Leaflet ◽  
Ross Procedure ◽  
Valve Repair ◽  
Artery Wall ◽  
Repair Technique ◽  
Aortic Valve Leaflet

Abstract Leaflet reconstruction outcomes in young patients can be compromised by treated autologous pericardium utilization. We present a new and simple unicuspid/unicommissural aortic valve repair technique with an autologous pulmonary artery wall graft. With comparative and longitudinal follow-up studies, this technique could constitute a living reconstruction of the aortic valve that does not preclude a future Ross procedure.

scholarly journals Cure of bartonella endocarditis of a prosthetic aortic valve without surgery: value of serologic follow-up

2003 ◽  
Vol 9 (3) ◽  
pp. 239-241 ◽  
Author(s):  
P. Lesprit ◽  
V. NoéUl ◽  
P. ChazouilléGres ◽  
C. Brun-Buisson ◽  
L. Deforges
Keyword(s):  
Aortic Valve ◽  
Prosthetic Aortic Valve

Ross procedure is a safe treatment option for aortic valve endocarditis: Long-term follow-up of 42 patients

2016 ◽  
Vol 203 ◽  
pp. 62-68 ◽  
Author(s):  
A. Ringle ◽  
M. Richardson ◽  
F. Juthier ◽  
N. Rousse ◽  
A.S. Polge ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Treatment Option ◽  
Ross Procedure ◽  
Safe Treatment ◽  
Long Term Follow Up ◽  
Safe Treatment Option

scholarly journals Pregnancy outcome and follow-up cardiac outcome in women with aortic valve replacement

2014 ◽  
Vol 7 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Snehalata Basude ◽  
Johanna Trinder ◽  
Massimo Caputo ◽  
Stephanie L Curtis
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Loss Rate ◽  
Fetal Loss ◽  
Mechanical Valve ◽  
Cardiac Outcomes ◽  
Fetal Complications ◽  
Cardiac Outcome

Objectives To compare the maternal, fetal and cardiac outcomes in women who have undergone aortic valve replacement. Method Retrospective observational study of all women with aortic valve replacement, who underwent a pregnancy (1998–2012). Maternal-, fetal- and valve-related cardiac outcomes were assessed. Results Thirty-two pregnancies in 16 women with aortic valve replacement (nine bioprosthetic, six Ross and 17 mechanical) were evaluated. There were no adverse maternal events in the bioprosthetic and Ross groups but three in the mechanical group. Fetal loss rate was highest in the mechanical valve pregnancies (53%). One woman in the bioprosthetic group needed valve re-operation, and one woman in the mechanical valve group died. There was no difference in the change of Vmax over the follow-up between the valves ( p = 0.25). Conclusions There was no difference in deterioration between aortic valve replacements during and after pregnancy. The highest risk of maternal and fetal complications occurred in the mechanical valve group.

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