Faculty Collaboration Database

The Supported vs Unsupported Ross in Pediatric Patients: Neoaortic Root and Ventricular Function. Ann Thorac Surg 2023 Feb;115(2):453-460

Date

07/13/2022

Pubmed ID

35820490

DOI

10.1016/j.athoracsur.2022.05.066

Scopus ID

2-s2.0-85138188934 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

BACKGROUND: The supported Ross is used to mitigate the neoaortic root dilation that has been described with the unsupported Ross. There is limited literature assessing the efficacy of the supported Ross in young patients. In this study, the fate of the neoaortic root was compared in the supported and unsupported Ross procedure in adolescent patients.

METHODS: A retrospective review was performed of patients who underwent the Ross procedure between 1996 and 2019. An analysis was conducted of patients aged 10 to 18 years who underwent the supported and unsupported Ross operation, without a Konno enlargement, to assess for longitudinal echocardiographic changes. Given differences in follow-up time, both regression analysis and Mann-Whitney nonparametric tests were used to correct for time from discharge to most recent follow-up.

RESULTS: The median follow-up time for supported and unsupported Ross patients without a Konno enlargement was 2.90 years (0.21-13.03 years) and 12.13 years (2.63-19.47 years), respectively. Unsupported Ross patients experienced a higher rate of change per year in the aortic annulus (P = .003 and P = .014) and aortic sinus (P = .002 and P = .002) diameters, respectively. There was no significant difference in the rate of change of end-diastolic left ventricular internal diameter (P = .703 and P = .92) and aortic insufficiency (P = .687 and P = .215) between the supported and unsupported Ross patients.

CONCLUSIONS: Progressive dilation of the neoaortic root in unsupported Ross patients is significantly mitigated with the supported Ross with excellent stability. The supported Ross is safe and effective and may play an increasing role in the management of children with aortic disease.

Author List

Sow M, Ginde S, Bartz P, Cohen S, Gerardin J, Kuhn E, Jaquiss R, Litwin SB, Woods RK, Hraska V, Tweddell JS, Mitchell ME

Authors

Peter J. Bartz MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Jennifer Gerardin MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Salil Ginde MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin
Viktor Hraska MD Professor in the Surgery department at Medical College of Wisconsin
Michael Edward Mitchell MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Ronald K. Woods MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Aortic Valve
Aortic Valve Insufficiency
Aortic Valve Stenosis
Cardiac Surgical Procedures
Child
Dilatation, Pathologic
Follow-Up Studies
Heart Valve Prosthesis Implantation
Humans
Pulmonary Valve
Retrospective Studies
Ventricular Function