Autograft Regurgitation and Aortic Root Dimensions After the Ross Procedure
Key result
The subcoronary technique for the Ross procedure resulted in a lower initial autograft regurgitation grade (0.38 vs 0.73) and annual increase (0.0231 vs 0.0259) compared to root replacement.
Why the study?
Does the subcoronary implantation technique compared to root replacement reduce autograft regurgitation and root dilatation in patients undergoing the Ross procedure?
Population
1014 patients from the German Ross Registry who underwent the Ross procedure between 1990 and 2006.
Comparison
Ross procedure using the subcoronary… vs Ross procedure using the root replacement…
Design
Cohort
Follow-up
mean 4.41+/-3.11 years, median 3.93 years
Authors
Discussion
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Member takes
Implication
May support subcoronary technique to limit regurgitation; hypothesis-generating and should not yet change practice.
Study Design
Type
Cohort (n=1,014)
Multicenter
Yes
Structured PICO
Does the subcoronary implantation technique compared to root replacement reduce autograft regurgitation and root dilatation in patients undergoing the Ross procedure?
P
Population
1,014 patients (mean age 41.2 years, 22.5% female) undergoing the Ross procedure using subcoronary or root replacement techniques, followed for a mean of 4.41 years.
E
Exposure
Ross procedure using the subcoronary implantation technique (n=521)
C
Comparator
Ross procedure using the root replacement technique (n=493)
O
Outcome
Development of autograft regurgitation and root dilatation (annulus, sinus, and sinotubular junction dimensions) measured by serial echocardiographysurrogate
Main Result
Absolute Event Rate: 0.0231% vs 0.0259%
The subcoronary implantation technique for the Ross procedure appears to prevent progressive dilatation of the aortic root compared to the root replacement technique.
Cite This Study
Hanke et al. (2007) conducted a cohort in Aortic valve disease requiring Ross procedure (n=1,014). Subcoronary implantation technique vs. Root replacement technique was evaluated on Annual increase in autograft regurgitation grade. The subcoronary technique for the Ross procedure resulted in a lower initial autograft regurgitation grade (0.38 vs 0.73) and annual increase (0.0231 vs 0.0259) compared to root replacement.