The Ross Procedure in Children: Defining the Optimal Age.
Heart Lung Circ
; 32(6): 745-749, 2023 Jun.
Article
em En
| MEDLINE
| ID: mdl-37173212
ABSTRACT
BACKGROUND:
It has been proposed that delaying the Ross procedure to later in childhood, allowing autograft stabilisation and placement of a larger pulmonary conduit, may improve outcomes. However, the effect of age at the time of Ross procedure on outcomes remains unclear.METHODS:
All patients who underwent the Ross procedure between 1995 and 2018 were included in the study. Patients were divided into four groups infants, age 1 to 5 years, age 5 to 10 years and age 10 to 18 years.RESULTS:
A total of 140 patients underwent the Ross procedure in the study period. Early mortality was 23.3% (7/30) for infants compared to 0% for older children (p<0.001). Survival at 15 years was significantly lower in infants (76.3%±9.9%), compared to children aged 1 to 5 years (90.9%±20.1%), 5 to 10 years (94%±13.3%), and 10 to 18 years (86.7%±10.0%), p=0.01. Freedom from autograft reoperation at 15 years was significantly lower in infants (58.4%±16.2%), compared to children aged 1 to 5 years (77.1%±14.9%), 5 to 10 years (84.2%±6.0%) and 10 to 18 years (87.8%±9.0%), p=0.01. Overall freedom from reoperation at 15 years was 13.0%±6.0% for infants, 24.2%±9.0% for children aged 1 to 5 years, 46.7%±15.8% for children aged 5 to 10 years, and 78.4%±10.4%, p<0.001.CONCLUSIONS:
The Ross procedure performed after 10 years of age appears to be associated with improved freedom from reoperation, primarily due to a reduction in reoperation on the pulmonary conduit.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência da Valva Aórtica
/
Estenose da Valva Aórtica
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Valva Pulmonar
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Próteses Valvulares Cardíacas
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Implante de Prótese de Valva Cardíaca
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Humans
/
Infant
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article