September 14, 2009Circulation
Autograft Reinforcement to Preserve Autograft Function After the Ross Procedure
Key result
Autograft reinforcement during the root replacement Ross procedure was associated with a significantly lower reoperation rate compared to no reinforcement (2.3% vs 12.9%; P<0.001).
Why the study?
Does autograft reinforcement reduce reoperation rates and preserve autograft function in adult patients undergoing the Ross procedure?
Population
1335 adult patients who underwent a Ross procedure
Comparison
Autograft reinforcement of the annulus… vs No autograft reinforcement (Root-R or SC-R)
Design
Cohort
Follow-up
mean 6.09+/-3.97 years (range 0.01 to 19.2 years)
Authors
Discussion
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Implication
Root reinforcement may lower reoperation after Ross root replacement; leaves open need for randomized confirmation before practice change.
Study Design
Type
Cohort (n=1,335)
Structured PICO
Does autograft reinforcement reduce reoperation rates and preserve autograft function in adult patients undergoing the Ross procedure?
P
Population
1,335 adult patients (mean age 43.5 years) undergoing a Ross procedure (subcoronary or root replacement), followed for a mean of 6.09 years.
E
Exposure
Autograft reinforcement (R) of the annulus, sinotubular junction, or both (n=592)
C
Comparator
No autograft reinforcement (Root-R or SC-R)
O
Outcome
Reoperation rate, aortic regurgitation (AR) development, and autograft dilatation over timehard clinical
Main Result
Absolute Event Rate: 2.3% vs 12.9%
p-value: p=<0.001
Surgical stabilization of the autograft during the Ross procedure, particularly in root replacement, significantly reduces reoperation rates and preserves long-term autograft function.
Cite This Study
Charitos et al. (2009) conducted a cohort in Aortic valve disease requiring Ross procedure (n=1,335). Autograft reinforcement vs. No autograft reinforcement was evaluated on Reoperation rate (p=<0.001). Autograft reinforcement during the root replacement Ross procedure was associated with a significantly lower reoperation rate compared to no reinforcement (2.3% vs 12.9%; P<0.001).