Aortic valve replacement in neonates and infants was associated with a 3.5-fold higher adjusted odds of in-hospital mortality compared to the Ross procedure.
Cohort (n=167)
Yes
Does the type of systemic semilunar valve replacement (AVR or TVR vs. Ross procedure) affect in-hospital and long-term mortality in neonates and infants?
Systemic semilunar valve replacement in neonates and infants carries high mortality, with the Ross procedure demonstrating better short- and long-term survival compared to AVR.
Effect estimate: aOR 3.47 (95% CI 1.51-7.93)
Absolute Event Rate: 48.9% vs 23.2%
p-value: p=0.003
Abstract Systemic semilunar valve replacement in neonates and infants is rare and usually a last resort. We analyzed Pediatric Cardiac Care Consortium data for patients undergoing Ross, aortic valve replacement (AVR), or truncal valve replacement (TVR) from 1982–2011 across 35 centers, with mortality tracked via the US National Death Index through 2022. Among 167 patients, in-hospital mortality was 23% for Ross, 49% for AVR, and 52% for TVR. Twenty-five–year survival was 59%, 29%, and 41%, respectively. Neonatal age (vs. infant) was associated with increased in-hospital and long-term mortality (OR 2.5, 3.9, respectively), while higher surgical weight was protective (OR 0.67, 0.61 per kg, respectively). The earlier surgical era was associated with higher in-hospital mortality (OR 3.4). AVR had over threefold in-hospital and long-term mortality (OR 3.2, 3.4, respectively). These results highlight the historically high risk of systemic semilunar valve replacement in this population and the need for innovative surgical approaches.
Masri et al. (Mon,) conducted a cohort in Systemic semilunar valve disease requiring replacement (n=167). Aortic valve replacement (AVR) vs. Ross procedure was evaluated on In-hospital mortality (aOR 3.47, 95% CI 1.51-7.93, p=0.003). Aortic valve replacement in neonates and infants was associated with a 3.5-fold higher adjusted odds of in-hospital mortality compared to the Ross procedure.