The Ross proceudre is a mainstay in the surgical treatment of irreparable aortic valve disease and outflow tract obstruction in children. Generally, in children, the expectation is that re-interventions on the homograft would be more common than those on the autograft. The recently published Italian multicenter Paediatric Ross Registry presented the 23 years nationwide experience with Ross operation in children, with paritcular attention to the second decade after Ross operation.
In a group of 305 children, the authors report very good survival which extended in the second decade after the Ross operation. However the study showed a higher than anticipated autograft reintevention rate, even higher than homograft related reintervention rate. Pulmonary autograft reoperation rate was 6% at 5 years from Ross operation, 14% at 10 years and 25% at 15 years. Risk fators for autograft reinterventions were age younger than 1 year at Ross operation, prior aortic procedure, use of subcoronary technique and need for associated procedures.
The present report confirms that the Ross operation is a safe and reproducible operation. However, left heart morbidity is higher than expected in the second decade after the operation. The identification of demographic and operative variables which impact on long term morbidity might optimize the selction of patients for the Ross procedure.
The full text is available at:http://www.ncbi.nlm.nih.gov/pubmed/25056868
In a group of 305 children, the authors report very good survival which extended in the second decade after the Ross operation. However the study showed a higher than anticipated autograft reintevention rate, even higher than homograft related reintervention rate. Pulmonary autograft reoperation rate was 6% at 5 years from Ross operation, 14% at 10 years and 25% at 15 years. Risk fators for autograft reinterventions were age younger than 1 year at Ross operation, prior aortic procedure, use of subcoronary technique and need for associated procedures.
The present report confirms that the Ross operation is a safe and reproducible operation. However, left heart morbidity is higher than expected in the second decade after the operation. The identification of demographic and operative variables which impact on long term morbidity might optimize the selction of patients for the Ross procedure.
The full text is available at:http://www.ncbi.nlm.nih.gov/pubmed/25056868
Dr. Alessandro Giardini
Paediatric Cardiologist in London
www.childheartspecialist.com
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