Outcomes and Quality of Life After Ross Reintervention: Would You Make the Same Choice Again?

Varrica, Alessandro; Caldaroni, Federica; Saitto, Guglielmo; Satriano, Angela; Rito, Mauro Lo; Chiarello, Carmelina; Ranucci, Marco; Frigiola, Alessandro; Giamberti, Alessandro

doi:10.1016/j.athoracsur.2019.10.007

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…In-hospital mortality was similar in both groups at 0.4%, whereas cumulative six-year reintervention rates (0.7%±0.7% vs. 4%±2%) and survival (98%±2% vs. 96%±2%) did not significantly differ between patients older than fifty years compared to those aged fifty years or younger. Moreover, while the risk of reinterventions is low after primary Ross in specialized centers, reoperations can be performed with excellent outcomes and quality of life (40). Varrica et al reoperated on sixty-four patients (forty-nine autograft, twenty-five homograft) with a median age of thirty-one years, followed up for a mean period of seventy-seven months (40).…”

Section: Vsrr Proceduresmentioning

confidence: 99%

“…Moreover, while the risk of reinterventions is low after primary Ross in specialized centers, reoperations can be performed with excellent outcomes and quality of life (40). Varrica et al reoperated on sixty-four patients (forty-nine autograft, twenty-five homograft) with a median age of thirty-one years, followed up for a mean period of seventy-seven months (40). Patients reported high quality of life on follow-up, with only one non-cardiac-related death-encouraging results in the context of young patients facing a lifetime of consequences stemming from their valve-replacement choice.…”

Section: Vsrr Proceduresmentioning

confidence: 99%

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The Ross procedure and valve-sparing root replacement procedures in the adult patient: do guidelines follow the evidence?

Vervoort¹,

El-Hamamsy²,

Chu³

et al. 2021

Ann Cardiothorac Surg

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Prosthetic aortic valve replacements have long been the mainstay of valvular surgery due to their favorable outcomes and low operative complexity. Yet, mechanical valves require lifelong anticoagulation, whereas bioprosthetic valves increase the risk for earlier and more frequent reoperation. Alternative reconstructive techniques have been proposed to address these challenges. These include valve-sparing root replacement procedures if the native aortic valve can be salvaged, and the Ross procedure, which nearly eliminates prosthetic valve-related thromboembolism, anticoagulation-related hemorrhage and endocarditis. Both procedures are technically more complex and thus subject to surgeons' volume and expertise compared to conventional aortic valve replacements. However, they are associated with more favorable outcomes compared to aortic valve replacements if performed by experienced surgeons, especially in younger patients.Nevertheless, despite the growing high-quality literature supporting both procedures, existing multisociety guidelines fail to acknowledge the strength of evidence in support of valve-sparing root replacement procedures and the Ross procedure. In this review, we summarize the existing long-term evidence for the use of each procedure, describe the current guidelines for the treatment of aortic valve pathology, and propose the reevaluation of guidelines based on the available clinical evidence.

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Section: Vsrr Proceduresmentioning

confidence: 99%

Section: Vsrr Proceduresmentioning

confidence: 99%