Ross procedure or complex aortic valve repair using pericardium in children: A real dilemma

Abstract

Informed consent statement: In accordance with our committee for the protection of human subjects, written informed consent for demographic and outcome data analyses was collected in compliance with French law on retrospective studies consisting of analyses of anonymous data.

Bicuspid Aortic Valve in Children and Adolescents: A Comprehensive Review

“…Danial and colleagues compared patients undergoing to complex aortic valve repair with patients undergoing the Ross operation with propensity score matching. The authors highlighted some important advantages in the group managed by aortic valve repair; they reported a lower morbidity, probably due to the minor complexity of the repair procedure versus the Ross operation, and a lower overall incidence of IE [ 66 ]. Therefore, several authors suggest postponing the Ross operation beyond infancy, ideally into adulthood, and recommend aortic valve repair in growing children [ 64 ].…”

Commentary: Aortic valve surgery in children: Repair now, Ross procedure later

“…10 Danial and colleagues have provided important additional information, demonstrating that complex aortic valve repair with the use of patch material can provide similar freedom from reoperation to the Ross procedure. 5 These findings should encourage us to continue to push the boundaries of which aortic valves can be repaired. In doing so, it should be possible to delay the Ross procedure for as long as possible and, hopefully, minimize the lifetime risk of prosthetic aortic valve replacement.…”

“…Over the last few years, it has become increasingly apparent that an initial approach of surgical aortic valve repair in children provides excellent survival and acceptable freedom from reoperation. [1][2][3][4][5][6][7] A strategy of avoiding balloon dilatation with uncontrolled tear of the aortic valve allows for a good quality initial repair and as such results in better freedom from reintervention. 6,7 Although the Ross procedure is associated with increased mortality in infants and neonates, it has excellent outcomes in older children.…”

Unicuspid aortic valve repair—Same principles, different methods

“…Furthermore, efforts to increase durability of repair seem to be becoming crucial in decision-making in pediatric and adolescent patients following the modern concept of a staged approach to UAV with repair as the first. [11][12][13] We read with great interest the recent paper on the congenital UAV repair by Dr. El-Khoury. 14 The technique presented in a recent JOCS issue proposes repair without a patch but based on the mobilization and preservation of as much own tissue as possible.…”

“…Furthermore, efforts to increase durability of repair seem to be becoming crucial in decision‐making in pediatric and adolescent patients following the modern concept of a staged approach to UAV with repair as the first 11–13 …”