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Rethinking the ross procedure in adults.

Publication ,  Journal Article
Reece, TB; Welke, KF; O'Brien, S; Grau-Sepulveda, MV; Grover, FL; Gammie, JS
Published in: Ann Thorac Surg
January 2014

BACKGROUND: Although questionable durability has tempered enthusiasm for the Ross procedure in the last decade, the perioperative risks of the Ross procedure relative to conventional aortic valve replacement are not well described. The goal of this study is to describe both the perioperative outcomes and utilization trends of the Ross procedure in adults in The Society of Thoracic Surgeons Adult Cardiac Surgery Database. METHODS: The Society of Thoracic Surgeons Adult Cardiac Surgery Database was used to review all Ross procedures performed between 1994 and 2010. The utilization of the procedure in the database was assessed. Then the preoperative comorbidities, patient demographics, and risk factors were reviewed, as were intraoperative and perioperative outcomes. RESULTS: Of 648,541 aortic valve replacements during the study period, 3,054 (0.47%) were identified as Ross procedures. Utilization of the procedures as a percent of total aortic valve replacements peaked in 1998 at 1.2%, followed by a steady decline to 0.09% by 2010. More than a quarter of all Ross operations were performed at six sites. Using propensity-matching analyses, Ross patients experienced significantly more perioperative complications including reexploration (9.4% versus 5.8%; p < 0.01), renal failure (2.6% versus 0.8%; p < 0.001), and operative mortality (2.7% versus 0.9%; p = 0.001). CONCLUSIONS: These data suggest that the Ross procedure is associated with greater perioperative morbidity and mortality risks compared with conventional aortic valve replacement. Recognition of these risks along with durability concerns have resulted in a dramatic decline in the number of Ross procedures performed in North America in the last decade.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2014

Volume

97

Issue

1

Start / End Page

175 / 181

Location

Netherlands

Related Subject Headings

  • United States
  • Ultrasonography
  • Treatment Outcome
  • Transplantation, Autologous
  • Survival Analysis
  • Societies, Medical
  • Risk Assessment
  • Respiratory System
  • Pulmonary Valve
  • Postoperative Complications
 

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Reece, T. B., Welke, K. F., O’Brien, S., Grau-Sepulveda, M. V., Grover, F. L., & Gammie, J. S. (2014). Rethinking the ross procedure in adults. Ann Thorac Surg, 97(1), 175–181. https://doi.org/10.1016/j.athoracsur.2013.07.036
Reece, T Brett, Karl F. Welke, Sean O’Brien, Maria V. Grau-Sepulveda, Frederick L. Grover, and James S. Gammie. “Rethinking the ross procedure in adults.Ann Thorac Surg 97, no. 1 (January 2014): 175–81. https://doi.org/10.1016/j.athoracsur.2013.07.036.
Reece TB, Welke KF, O’Brien S, Grau-Sepulveda MV, Grover FL, Gammie JS. Rethinking the ross procedure in adults. Ann Thorac Surg. 2014 Jan;97(1):175–81.
Reece, T. Brett, et al. “Rethinking the ross procedure in adults.Ann Thorac Surg, vol. 97, no. 1, Jan. 2014, pp. 175–81. Pubmed, doi:10.1016/j.athoracsur.2013.07.036.
Reece TB, Welke KF, O’Brien S, Grau-Sepulveda MV, Grover FL, Gammie JS. Rethinking the ross procedure in adults. Ann Thorac Surg. 2014 Jan;97(1):175–181.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2014

Volume

97

Issue

1

Start / End Page

175 / 181

Location

Netherlands

Related Subject Headings

  • United States
  • Ultrasonography
  • Treatment Outcome
  • Transplantation, Autologous
  • Survival Analysis
  • Societies, Medical
  • Risk Assessment
  • Respiratory System
  • Pulmonary Valve
  • Postoperative Complications