Long-term outcomes after the paediatric Ross and Ross-Konno procedures

Schlein, Johanna; Ebner, Barbara Elisabeth; Geiger, Ralf; Simon, Paul; Wollenek, Gregor; Moritz, Anton; Gamillscheg, Andreas; Base, Eva; Laufer, Günther; Zimpfer, Daniel

doi:10.1093/icvts/ivab093

Cited by 5 publications

(1 citation statement)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Postponing a Ross at a young age may therefore be sensible if the valve is amenable to repair. 93 , 94 Improvements in repair techniques to achieve a durable result may thus be of benefit to children with AVD. 89 , 95–97 …”

Section: Discussionmentioning

confidence: 99%

Paediatric aortic valve replacement: a meta-analysis and microsimulation study

Notenboom

Schuermans

Etnel

et al. 2023

European Heart Journal

View full text Add to dashboard Cite

Aims To support decision-making in children undergoing aortic valve replacement (AVR), by providing a comprehensive overview of published outcomes after paediatric AVR, and microsimulation-based age-specific estimates of outcome with different valve substitutes. Methods and results A systematic review of published literature reporting clinical outcome after paediatric AVR (mean age <18 years) published between 1/1/1990 and 11/08/2021 was conducted. Publications reporting outcome after paediatric Ross procedure, mechanical AVR (mAVR), homograft AVR (hAVR), and/or bioprosthetic AVR were considered for inclusion. Early risks (<30d), late event rates (>30d) and time-to-event data were pooled and entered into a microsimulation model. Sixty-eight studies, of which one prospective and 67 retrospective cohort studies, were included, encompassing a total of 5259 patients (37 435 patient-years; median follow-up: 5.9 years; range 1–21 years). Pooled mean age for the Ross procedure, mAVR, and hAVR was 9.2 ± 5.6, 13.0 ± 3.4, and 8.4 ± 5.4 years, respectively. Pooled early mortality for the Ross procedure, mAVR, and hAVR was 3.7% (95% CI, 3.0%–4.7%), 7.0% (5.1%–9.6%), and 10.6% (6.6%–17.0%), respectively, and late mortality rate was 0.5%/year (0.4%–0.7%/year), 1.0%/year (0.6%–1.5%/year), and 1.4%/year (0.8%–2.5%/year), respectively. Microsimulation-based mean life-expectancy in the first 20 years was 18.9 years (18.6–19.1 years) after Ross (relative life-expectancy: 94.8%) and 17.0 years (16.5–17.6 years) after mAVR (relative life-expectancy: 86.3%). Microsimulation-based 20-year risk of aortic valve reintervention was 42.0% (95% CI: 39.6%–44.6%) after Ross and 17.8% (95% CI: 17.0%–19.4%) after mAVR. Conclusion Results of paediatric AVR are currently suboptimal with substantial mortality especially in the very young with considerable reintervention hazards for all valve substitutes, but the Ross procedure provides a survival benefit over mAVR. Pros and cons of substitutes should be carefully weighed during paediatric valve selection.

show abstract

Section: Discussionmentioning

confidence: 99%

Paediatric aortic valve replacement: a meta-analysis and microsimulation study

Notenboom

Schuermans

Etnel

et al. 2023

European Heart Journal

View full text Add to dashboard Cite

show abstract

Aortic Valve Repair in Pediatric Patients: 30 Years Single Center Experience

Schlein

Kaider

Gabriel

et al. 2023

The Annals of Thoracic Surgery

Self Cite

View full text Add to dashboard Cite

JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair

Ohuchi

Kawata²,

Uemura

et al. 2022

Circ J

View full text Add to dashboard Cite

9JCS 2022 Guideline on Management/Re-Intervention in ACHD comorbidity, 172 and cardiac catheterization is fundamental for its evaluation. 173 ▋ 3.4.4 Left Heart Catheterization and Coronary Angiography Echocardiography, CT, and MRI are often substituted for left ventriculography, aortography, or coronary angiography. CT precisely illustrates abnormal origins and courses of the coronary arteries in many cases, which is why coronary angiography is not recommended as a routine examination (Class III). In some patients, nonetheless, coronary angiography is quite informative beyond CT resolution; for example, anastomotic stenosis at the coronary arterial origin would be better demonstrated by catheter angiography after the arterial switch procedure. 174 ▋ 3.4.5 Endomyocardial Biopsy Endomyocardial biopsy is rarely required in patients with postoperative CHD. ▋ 3.4.6 Catheter InterventionTranscatheter closure of atrial septal defect or patent ductus arteriosus is carried out routinely in the cardiac catheterization room, as is percutaneous pulmonary angioplasty. Interventional closure of ventricular septal defect needs more evidence before becoming established in Japan.Transcatheter pulmonary valve replacement will be introduced in the near future.Electrophysiological study and catheter ablation are common practices for arrhythmias in the CHD field. Recent advances in technology and devices, such as 3D mapping systems, have contributed to notable results in anti-arrythmic treatments in patients with repaired CHD. 175

show abstract

Long-term outcomes after the paediatric Ross and Ross-Konno procedures

Cited by 5 publications

References 21 publications

Paediatric aortic valve replacement: a meta-analysis and microsimulation study

Paediatric aortic valve replacement: a meta-analysis and microsimulation study

Aortic Valve Repair in Pediatric Patients: 30 Years Single Center Experience

JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair

Contact Info

Product

Resources

About