Ross procedure in infants and toddlers followed into childhood

Ismee A. Williams, Jan M. Quaegebeur, Daphne T. Hsu, Welton M. Gersony, Francois Bourlon, Ralph S. Mosca, Deborah R. Gersony, David E. Solowiejczyk

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background - The Ross procedure is commonly used to treat aortic valve disease in pediatric and adult patients. For infants, data are limited regarding survival, reintervention, autograft growth, and function. Methods and Results - The Ross procedure was performed in 27 infants <18 months of age (median age 5.7 months). All patients had congenital aortic stenosis (AS); associated lesions included subAS (n=9), supravalvular AS (n=2), coarctation (n=5), and interrupted aortic arch (n=2). Median follow-up was 6.1 years (range 0.2 to 12.9). There were 3 early deaths and no late deaths. Freedom from reintervention for homograft dysfunction was 87% at 8 years; freedom from autograft reintervention was 100%. Follow-up echocardiograms were available in 17 patients. Estimated peak autograft gradient was 55 mm Hg in one patient and <10 mm Hg in 16. Mild autograft insufficiency was seen in 4 patients; 13 had none. Autograft diameter was measured early postoperatively and at latest follow-up. The mean z score increased from 0.63 to 3.2 (P<0.01) at the annulus and from 0.26 to 2.2 (P<0.01) at the sinus. In a subgroup, the mean autograft z score increased significantly from the postoperative period to 1 year for both the annulus (0.72 to 3.2, P<0.01) and the sinus (0.26 to 2.2, P<0.01), but remained unchanged thereafter. Conclusions - The Ross procedure effectively relieves AS in infants. Homograft reintervention occurred in 13% within 8 years. No patient developed significant autograft insufficiency or required autograft reintervention during the follow-up period. Dilatation of the autograft occurred during the first year after surgery and stabilized thereafter.

Original languageEnglish (US)
JournalCirculation
Volume112
Issue number9 SUPPL.
DOIs
StatePublished - Aug 30 2005
Externally publishedYes

Fingerprint

Autografts
Aortic Valve Stenosis
Allografts
Supravalvular Aortic Stenosis
Aortic Diseases
Thoracic Aorta
Aortic Valve
Postoperative Period
Dilatation
Pediatrics
Survival
Growth

Keywords

  • Aorta
  • Heart defects, congenital
  • Pediatrics
  • Surgery
  • Valves

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Williams, I. A., Quaegebeur, J. M., Hsu, D. T., Gersony, W. M., Bourlon, F., Mosca, R. S., ... Solowiejczyk, D. E. (2005). Ross procedure in infants and toddlers followed into childhood. Circulation, 112(9 SUPPL.). https://doi.org/10.1161/CIRCULATIONAHA.104.524975

Ross procedure in infants and toddlers followed into childhood. / Williams, Ismee A.; Quaegebeur, Jan M.; Hsu, Daphne T.; Gersony, Welton M.; Bourlon, Francois; Mosca, Ralph S.; Gersony, Deborah R.; Solowiejczyk, David E.

In: Circulation, Vol. 112, No. 9 SUPPL., 30.08.2005.

Research output: Contribution to journalArticle

Williams, IA, Quaegebeur, JM, Hsu, DT, Gersony, WM, Bourlon, F, Mosca, RS, Gersony, DR & Solowiejczyk, DE 2005, 'Ross procedure in infants and toddlers followed into childhood', Circulation, vol. 112, no. 9 SUPPL.. https://doi.org/10.1161/CIRCULATIONAHA.104.524975
Williams IA, Quaegebeur JM, Hsu DT, Gersony WM, Bourlon F, Mosca RS et al. Ross procedure in infants and toddlers followed into childhood. Circulation. 2005 Aug 30;112(9 SUPPL.). https://doi.org/10.1161/CIRCULATIONAHA.104.524975
Williams, Ismee A. ; Quaegebeur, Jan M. ; Hsu, Daphne T. ; Gersony, Welton M. ; Bourlon, Francois ; Mosca, Ralph S. ; Gersony, Deborah R. ; Solowiejczyk, David E. / Ross procedure in infants and toddlers followed into childhood. In: Circulation. 2005 ; Vol. 112, No. 9 SUPPL.
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abstract = "Background - The Ross procedure is commonly used to treat aortic valve disease in pediatric and adult patients. For infants, data are limited regarding survival, reintervention, autograft growth, and function. Methods and Results - The Ross procedure was performed in 27 infants <18 months of age (median age 5.7 months). All patients had congenital aortic stenosis (AS); associated lesions included subAS (n=9), supravalvular AS (n=2), coarctation (n=5), and interrupted aortic arch (n=2). Median follow-up was 6.1 years (range 0.2 to 12.9). There were 3 early deaths and no late deaths. Freedom from reintervention for homograft dysfunction was 87{\%} at 8 years; freedom from autograft reintervention was 100{\%}. Follow-up echocardiograms were available in 17 patients. Estimated peak autograft gradient was 55 mm Hg in one patient and <10 mm Hg in 16. Mild autograft insufficiency was seen in 4 patients; 13 had none. Autograft diameter was measured early postoperatively and at latest follow-up. The mean z score increased from 0.63 to 3.2 (P<0.01) at the annulus and from 0.26 to 2.2 (P<0.01) at the sinus. In a subgroup, the mean autograft z score increased significantly from the postoperative period to 1 year for both the annulus (0.72 to 3.2, P<0.01) and the sinus (0.26 to 2.2, P<0.01), but remained unchanged thereafter. Conclusions - The Ross procedure effectively relieves AS in infants. Homograft reintervention occurred in 13{\%} within 8 years. No patient developed significant autograft insufficiency or required autograft reintervention during the follow-up period. Dilatation of the autograft occurred during the first year after surgery and stabilized thereafter.",
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T1 - Ross procedure in infants and toddlers followed into childhood

AU - Williams, Ismee A.

AU - Quaegebeur, Jan M.

AU - Hsu, Daphne T.

AU - Gersony, Welton M.

AU - Bourlon, Francois

AU - Mosca, Ralph S.

AU - Gersony, Deborah R.

AU - Solowiejczyk, David E.

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N2 - Background - The Ross procedure is commonly used to treat aortic valve disease in pediatric and adult patients. For infants, data are limited regarding survival, reintervention, autograft growth, and function. Methods and Results - The Ross procedure was performed in 27 infants <18 months of age (median age 5.7 months). All patients had congenital aortic stenosis (AS); associated lesions included subAS (n=9), supravalvular AS (n=2), coarctation (n=5), and interrupted aortic arch (n=2). Median follow-up was 6.1 years (range 0.2 to 12.9). There were 3 early deaths and no late deaths. Freedom from reintervention for homograft dysfunction was 87% at 8 years; freedom from autograft reintervention was 100%. Follow-up echocardiograms were available in 17 patients. Estimated peak autograft gradient was 55 mm Hg in one patient and <10 mm Hg in 16. Mild autograft insufficiency was seen in 4 patients; 13 had none. Autograft diameter was measured early postoperatively and at latest follow-up. The mean z score increased from 0.63 to 3.2 (P<0.01) at the annulus and from 0.26 to 2.2 (P<0.01) at the sinus. In a subgroup, the mean autograft z score increased significantly from the postoperative period to 1 year for both the annulus (0.72 to 3.2, P<0.01) and the sinus (0.26 to 2.2, P<0.01), but remained unchanged thereafter. Conclusions - The Ross procedure effectively relieves AS in infants. Homograft reintervention occurred in 13% within 8 years. No patient developed significant autograft insufficiency or required autograft reintervention during the follow-up period. Dilatation of the autograft occurred during the first year after surgery and stabilized thereafter.

AB - Background - The Ross procedure is commonly used to treat aortic valve disease in pediatric and adult patients. For infants, data are limited regarding survival, reintervention, autograft growth, and function. Methods and Results - The Ross procedure was performed in 27 infants <18 months of age (median age 5.7 months). All patients had congenital aortic stenosis (AS); associated lesions included subAS (n=9), supravalvular AS (n=2), coarctation (n=5), and interrupted aortic arch (n=2). Median follow-up was 6.1 years (range 0.2 to 12.9). There were 3 early deaths and no late deaths. Freedom from reintervention for homograft dysfunction was 87% at 8 years; freedom from autograft reintervention was 100%. Follow-up echocardiograms were available in 17 patients. Estimated peak autograft gradient was 55 mm Hg in one patient and <10 mm Hg in 16. Mild autograft insufficiency was seen in 4 patients; 13 had none. Autograft diameter was measured early postoperatively and at latest follow-up. The mean z score increased from 0.63 to 3.2 (P<0.01) at the annulus and from 0.26 to 2.2 (P<0.01) at the sinus. In a subgroup, the mean autograft z score increased significantly from the postoperative period to 1 year for both the annulus (0.72 to 3.2, P<0.01) and the sinus (0.26 to 2.2, P<0.01), but remained unchanged thereafter. Conclusions - The Ross procedure effectively relieves AS in infants. Homograft reintervention occurred in 13% within 8 years. No patient developed significant autograft insufficiency or required autograft reintervention during the follow-up period. Dilatation of the autograft occurred during the first year after surgery and stabilized thereafter.

KW - Aorta

KW - Heart defects, congenital

KW - Pediatrics

KW - Surgery

KW - Valves

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