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 language | English (US) |
|---|---|
| Journal | Circulation |
| Volume | 112 |
| Issue number | 9 SUPPL. |
| DOIs | |
| State | Published - Aug 30 2005 |
| Externally published | Yes |
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Keywords
- Aorta
- Heart defects, congenital
- Pediatrics
- Surgery
- Valves
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
TY - JOUR
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.
PY - 2005/8/30
Y1 - 2005/8/30
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
UR - http://www.scopus.com/inward/record.url?scp=24644494168&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=24644494168&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.104.524975
DO - 10.1161/CIRCULATIONAHA.104.524975
M3 - Article
C2 - 16159852
AN - SCOPUS:24644494168
VL - 112
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 9 SUPPL.
ER -