Do surgical modifications at the annular level during the Ross procedure negatively influence the structural and functional durability of the autograft?

Détails

ID Serval
serval:BIB_06CC0D69E914
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Do surgical modifications at the annular level during the Ross procedure negatively influence the structural and functional durability of the autograft?
Périodique
Interactive cardiovascular and thoracic surgery
Auteur(s)
Lögers A., Rosser B., Seifert B., Kretschmar O., Hübler M., Prêtre R., Ben Mime L.
ISSN
1569-9285 (Electronic)
ISSN-L
1569-9285
Statut éditorial
Publié
Date de publication
01/11/2018
Peer-reviewed
Oui
Volume
27
Numéro
5
Pages
642-649
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Do surgical modifications at the annular level (e.g. the modified Ross-Konno procedure or reduction plasty) influence the structure and function of the Ross autograft at the mid-term follow-up?
From June 2001 to July 2009, 49 patients (37 men and 12 women), mean age 10.5 ± 5.7 years (range 2 weeks to 17.8 years), underwent Ross operations. Twenty-one patients underwent additional aortic annulus reduction plasty and 9 patients a modified Ross-Konno procedure. The need for reintervention, reoperation and valve function were retrospectively analysed for a mean follow-up of 4.6 ± 2.7 years (range 9 days to 9.2 years).
There were no intraoperative or early death. Three late deaths occurred. Survival at 4 years was 91.9 ± 4.6%. In the overall cohort, aortic annular growth was 1 mm/year, corresponding to a z-score increase of 0.24/year (no mismatch group), 0.21/year (reduction plasty group) and 0.34/year (Ross-Konno group). At the last follow-up, sinotubular junction z-scores were 2.8 ± 1, 3 ± 1 and 2.4 ± 0.9 in the no mismatch, reduction plasty, and Ross-Konno groups, respectively. Ninety-three percent of patients presented with none-to-mild autograft valve regurgitation. The Ross-Konno group showed a significant increase in aortic annulus size (z-score of the annulus at the last follow-up 3.6 ± 1.6; P = 0.036). The no mismatch and the reduction plasty groups showed z-scores within the normal range (2.1 ± 1.7 and 2.5 ± 1.6, respectively).
Additional aortic annulus reduction or enlargement does not disturb the structural and functional durability of the autograft at the mid-term follow-up. Long-term autograft integrity, especially in the Ross-Konno group, remains to be investigated.
Mots-clé
Adolescent, Aortic Valve/diagnostic imaging, Aortic Valve/surgery, Autografts, Cardiac Surgical Procedures/methods, Child, Child, Preschool, Echocardiography, Electrocardiography, Ambulatory, Female, Heart Valve Diseases/complications, Heart Valve Diseases/diagnosis, Heart Valve Diseases/surgery, Humans, Infant, Infant, Newborn, Male, Reoperation, Retrospective Studies, Ventricular Outflow Obstruction/etiology, Ventricular Outflow Obstruction/physiopathology, Ventricular Outflow Obstruction/surgery
Pubmed
Web of science
Open Access
Oui
Création de la notice
24/05/2018 18:44
Dernière modification de la notice
20/08/2019 13:29
Données d'usage