Key result
Ross procedure pulmonary autografts serve as ideal aortic valve conduits adaptable to stress and somatic growth.
Why the study?
Reports on the effectiveness, safety, and durability of the pulmonary autograft living tissue in the Ross procedure have shown variable results.
What are the mortality and morbidity outcomes after the Ross procedure using pulmonary autograft in pediatric and young adult patients with diseased aortic valve?
Systematic Review
What are the mortality and morbidity outcomes after the Ross procedure using pulmonary autograft in pediatric and young adult patients with diseased aortic valve?
The Ross procedure using pulmonary autograft provides an adaptable conduit for aortic valve replacement, with the miniroot technique potentially offering better adaptability to stress than subcoronary implantation.
Supports Ross procedure with pulmonary autograft in pediatric aortic valve disease; confirms growth adaptability in Level 1 evidence.
Background: Reports on effectiveness and safety after the implant of pulmonary autograft (PA) living tissue in Ross procedure, to treat both congenital and acquired disease of the aortic valve and left ventricular outflow tract (LVOT), show variable durability results. We undertake a quantitative systematic review of evidence on outcome after the Ross procedure with the aim to improve insight into outcome and potential determinants. Methods: A systematic search of reports published from October 1979 to January 2021 was conducted (PubMed, Ovid Medline, Ovid Embase and Cochrane library) reporting outcomes after the Ross procedure in patients with diseased aortic valve with or without LVOT. Inclusion criteria were observational studies reporting on mortality and/or morbidity after autograft aortic valve or root replacement, completeness of follow-up >90%, and study size n≥30. Forty articles meeting the inclusion criteria were allocated to two categories: pediatric patient series and young adult patient series. Results were tabulated for a clearer presentation. Results: the subcoronary approach. Discussion: The adaptability of lung autograft to allow for both stress variability and somatic growth make it an ideal conduit for Ross's operation. The use of the miniroot technique over subcoronary implantation for better adaptability to withstand varying degrees of stress is perhaps more applicable to different patient subgroups.
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Nappi et al. (2022) conducted a systematic review in Diseased aortic valve with or without LVOT. Ross procedure (pulmonary autograft) was evaluated on Mortality and/or morbidity. Pulmonary autograft in the Ross procedure provides adaptability for stress variability and somatic growth, making it an ideal conduit for treating diseased aortic valves.
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