Patient Age at the Ross Operation in Children Influences Aortic Root Dimensions and Aortic Regurgitation

Hörer, Jürgen; Kašnar-Šamprec, Jelena; Charitos, Efstratios I.; Stierle, Ulrich; Bogers, Ad J.J.C.; Hemmer, Wolfgang; Hetzer, Roland; Hübler, Michael; Robinson, Derek; Sievers, Hans H.; Lange, Rüdiger

doi:10.1177/2150135113485763

Cited by 15 publications

(8 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of 15 relevant articles were downloaded and among them, seven articles were used in the analysis [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] and eight articles were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart of meta-analyses is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and Safety of the Ozaki Procedure for Aortic Valve Disease in Pediatric Patients: A Systematic Review and Meta-Analysis

Halder,

Mishra,

Ghosh

et al. 2023

Cureus

View full text Add to dashboard Cite

The surgical treatment options for pediatric aortic valve disease are limited and have debatable long-term durability. In the current situation, the Ross procedure is considered in children for aortic valve disease(s). It is a complex surgical procedure with the risk of neo-aortic dilatation, converting a single valve disease into double valve disease, and associated with future re-interventions. Conversely, the Ozaki procedure has shown promising results in adults. Thus, the present study aimed to provide comparative evidence on the effectiveness and safety of the Ozaki versus Ross procedure for pediatric patients by performing a metaanalytic comparison of reporting outcomes. A total of 15 relevant articles were downloaded and among them, seven articles (one prospective study, five retrospective studies, and one case series) were used in the analysis. Primary outcomes such as physiological laminar flow pattern and hemodynamic parameters, and secondary outcomes such as hospital stays, adverse effects, mortality, and numbers of re-intervention(s) were measured in the meta-analysis. There were no significant differences in the age of patients between children who underwent the Ozaki procedure and those who underwent the Ross procedure at the time of surgeries. The Ozaki procedure is a good solution to an aortic problem(s) similar to the Ross procedure. Unlike the Ross procedure, the Ozaki procedure has restored a physiological laminar flow pattern in the short-term follow-up without the bi-valvular disease. Mean hospital stays (p = 0.048), mean follow-up (p = 0.02), adverse effects (p = 0.02), death, and numbers of re-intervention(s) of children who underwent the Ozaki procedure were fewer than those who underwent the Ross procedure. The time required for reintervention(s) is higher for children who underwent the Ozaki procedure than those who underwent the Ross procedure. None of the procedures, including the Ozaki procedure for aortic valve disease(s), has significant effects on hemodynamic parameters and the frequent death rate of children after surgeries. Based on our analysis, we may suggest the Ozaki procedure for aortic valve disease surgery in children.

show abstract

Section: Resultsmentioning

confidence: 99%

Effectiveness and Safety of the Ozaki Procedure for Aortic Valve Disease in Pediatric Patients: A Systematic Review and Meta-Analysis

Halder,

Mishra,

Ghosh

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…In fact David et al described the importance of the aortic annulus diameter as a risk factor for re-operation whenever the latter is over 27 mm or indexed > 16 mm/m2 (23). Horer et al (31), evidenced that the age of the patient at the time of Ross operation has a strong impact on the outcome greater than the impact of the initial aortic annulus size. Indeed, while a dilated annulus in children tends to normalize over time, in adolescents it tends to grow further and therefore ending up with autograft failure (32).…”

Section: Discussionmentioning

confidence: 99%

Ross Operation in Pediatric Population: Impact of the Surgical Timing and the Native Pulmonary Diameter on the Outcome

et al. 2022

View full text Add to dashboard Cite

Background: Aortic valve replacement early in life maybe inevitable at times. Ross operation until presentday remains the favorite surgical option in pediatrics with irreparable aortic valve disease. Nonetheless the necessity for re-operation was always its principal limitation due to aortic valve failure or homograft degeneration. We hereby present our 25 years of experience in pediatric population.Methods: From August 1994 until June 2018, a total of 157 children below 18 years underwent a Ross operation. This retrospective review aims at assessing long-term outcome likewise risk factors for reoperation after Ross procedure.Results: Median age was 10.9 years, of which 7 were infants, 79 children and 71 adolescents. Median follow-up was 14 years. Hospital mortality was 0.6%. Freedom from autograft re-operation for children was 96.7% and 94.1% at 10 and 20 years respectively, whereas for adolescents it was 92.6% and 74.9% at 10 and 20 years. For children freedom from homograft re-operation was 92.5%, 83.5% and 56.2% at 10, 15, and 20 years respectively. While for adolescents, it was 96.8%, 91.8%, and 86.7% at 10, 15, and 20 years. Homograft size (p=0.008) and childhood (p=0.05) were risk factors for homograft re-operation.Pulmonary valve diameter >24 mm (p=0.044) and adolescence (p=0.032) were risk factors for autograft re-operation.Conclusions: Our experience demonstrated excellent early and late survival. Whilst children have preferential outcomes concerning autograft re-operation, those who received a smaller homograft had higher incidences of right-sided re-intervention compared to adolescents. Pulmonary diameter >24mm at surgery was an indicator for future autograft failure.

show abstract

“…Amongst replacement options, the Ross operation has clear advantage over other alternatives, although operative mortality 1 , 2 , 4 , 5 , 22 and late complications are far from negligible. 6 , 23 , 24 Recently, AV Neo has been shown to be a versatile procedure in children with adequate haemodynamic parameters in the short- and medium-term follow-up, despite some concerns raised by the possible use of pericardial substitutes. 25 …”

Section: Discussionmentioning

confidence: 99%

Blood flow characteristics after aortic valve neocuspidization in paediatric patients: a comparison with the Ross procedure

Secinaro

Milano

Ciancarella

et al. 2021

European Heart Journal - Cardiovascular Imaging

View full text Add to dashboard Cite

Aims The aortic valve (AV) neocuspidization (Ozaki procedure) is a novel surgical technique for AV disease that preserves the natural motion and cardiodynamics of the aortic root. In this study, we sought to evaluate, by 4D-flow magnetic resonance imaging, the aortic blood flow characteristics after AV neocuspidization in paediatric patients. Methods and results Aortic root and ascending aorta haemodynamics were evaluated in a population of patients treated with the Ozaki procedure; results were compared with those of a group of patients operated with the Ross technique. Cardiovascular magnetic resonance studies were performed at 1.5 T using a 4D flow-sensitive sequence acquired with retrospective electrocardiogram-gating and respiratory navigator. Post-processing of 4D-flow analysis was performed to calculate flow eccentricity and wall shear stress. Twenty children were included in this study, 10 after Ozaki and 10 after Ross procedure. Median age at surgery was 10.7 years (range 3.9–16.5 years). No significant differences were observed in wall shear stress values measured at the level of the proximal ascending aorta between the two groups. The analysis of flow patterns showed no clear association between eccentric flow and the procedure performed. The Ozaki group showed just a slightly increased transvalvular maximum velocity. Conclusion Proximal aorta flow dynamics of children treated with the Ozaki and the Ross procedure are comparable. Similarly to the Ross, Ozaki technique restores a physiological laminar flow pattern in the short-term follow-up, with the advantage of not inducing a bivalvular disease, although further studies are warranted to evaluate its long-term results.

show abstract

Patient Age at the Ross Operation in Children Influences Aortic Root Dimensions and Aortic Regurgitation

Cited by 15 publications

References 21 publications

Effectiveness and Safety of the Ozaki Procedure for Aortic Valve Disease in Pediatric Patients: A Systematic Review and Meta-Analysis

Effectiveness and Safety of the Ozaki Procedure for Aortic Valve Disease in Pediatric Patients: A Systematic Review and Meta-Analysis

Ross Operation in Pediatric Population: Impact of the Surgical Timing and the Native Pulmonary Diameter on the Outcome

Blood flow characteristics after aortic valve neocuspidization in paediatric patients: a comparison with the Ross procedure

Contact Info

Product

Resources

About