Outcomes of the Ross procedure in patients older versus younger than 50 years old

Outcomes of the Ross procedure in patients older versus younger than 50 years old

Abstract OBJECTIVES The Ross procedure is traditionally considered for young adult patients with aortic valve disease. This study compares long-term outcomes of patients undergoing the Ross procedure who are ≥50 and

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Veröffentlicht in:European journal of cardio-thoracic surgery 2023-10, Vol.64 (4)
Hauptverfasser: Shih, Emily, Ryan, William H, Squiers, John J, Schaffer, Justin M, Harrington, Katherine B, Banwait, Jasjit K, Meidan, Talia G, DiMaio, J Michael, Brinkman, William T
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container_title European journal of cardio-thoracic surgery
container_volume 64
creator Shih, Emily
Ryan, William H
Squiers, John J
Schaffer, Justin M
Harrington, Katherine B
Banwait, Jasjit K
Meidan, Talia G
DiMaio, J Michael
Brinkman, William T
description Abstract OBJECTIVES The Ross procedure is traditionally considered for young adult patients with aortic valve disease. This study compares long-term outcomes of patients undergoing the Ross procedure who are ≥50 and
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This study compares long-term outcomes of patients undergoing the Ross procedure who are ≥50 and &lt;50-years old. METHODS Data were collected from 225 patients undergoing Ross procedure at a single centre from 1994 to 2019. Patients were categorized into younger (&lt;50-years old; n = 156) and older (≥50-years old; n = 69) cohorts. Baseline demographics clinical outcomes were compared. RESULTS The mean age was 36 ± 8.1 and 55 ± 4.2 years in the younger and older cohort, respectively. Both groups were predominantly male (58.5% vs 69.6%; P = 0.59). The younger group had a higher rate of aortic insufficiency (51% vs 26.1%; P &lt; 0.01), and bicuspid aortic valve (81.4% vs 58.0%; P &lt; 0.01). Aortic stenosis was more prevalent in the older cohort (25.6% vs 58.0%; P &lt; 0.01). Operative mortality was acceptable in both groups (1.3% vs 4.3%; P = 0.15). Survival up to 10 years was not statistically different between 2 groups (96.2% vs 91.3% P = 0.16), whereas survival up to 15 years for younger patients was significantly higher (94.9% vs 85.5%; P = 0.03). After non-cardiac related deaths were excluded, survival up to 15 years (98.7% vs 91.3%; P = 0.02) was significantly lower than younger patients. In both groups, survival after the Ross procedure was similar to the age- and sex-matched US population. CONCLUSIONS Survival up to 10 years after Ross procedure were similar, but up to 15 years was significantly higher in younger patients. The Ross procedure restored patients from both groups to expected survival. Our results suggest that at experienced centres, the Ross procedure is a safe and reasonable option for patients who are 50 years and older. The Ross procedure is traditionally offered to young adult patients with expected long-term survival to avoid the potential of early bioprosthetic valve failure and the risk of long-term anticoagulation and shortened life expectancy with mechanical valves [1, 2].</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezad260</identifier><identifier>PMID: 37439708</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><ispartof>European journal of cardio-thoracic surgery, 2023-10, Vol.64 (4)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-3532cda2cac9f803f11f11afdb58838cfe20121497094786764435f8815e519f3</citedby><cites>FETCH-LOGICAL-c326t-3532cda2cac9f803f11f11afdb58838cfe20121497094786764435f8815e519f3</cites><orcidid>0000-0002-6064-5869 ; 0000-0002-2426-513X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37439708$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shih, Emily</creatorcontrib><creatorcontrib>Ryan, William H</creatorcontrib><creatorcontrib>Squiers, John J</creatorcontrib><creatorcontrib>Schaffer, Justin M</creatorcontrib><creatorcontrib>Harrington, Katherine B</creatorcontrib><creatorcontrib>Banwait, Jasjit K</creatorcontrib><creatorcontrib>Meidan, Talia G</creatorcontrib><creatorcontrib>DiMaio, J Michael</creatorcontrib><creatorcontrib>Brinkman, William T</creatorcontrib><title>Outcomes of the Ross procedure in patients older versus younger than 50 years old</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>Abstract OBJECTIVES The Ross procedure is traditionally considered for young adult patients with aortic valve disease. This study compares long-term outcomes of patients undergoing the Ross procedure who are ≥50 and &lt;50-years old. METHODS Data were collected from 225 patients undergoing Ross procedure at a single centre from 1994 to 2019. Patients were categorized into younger (&lt;50-years old; n = 156) and older (≥50-years old; n = 69) cohorts. Baseline demographics clinical outcomes were compared. RESULTS The mean age was 36 ± 8.1 and 55 ± 4.2 years in the younger and older cohort, respectively. Both groups were predominantly male (58.5% vs 69.6%; P = 0.59). The younger group had a higher rate of aortic insufficiency (51% vs 26.1%; P &lt; 0.01), and bicuspid aortic valve (81.4% vs 58.0%; P &lt; 0.01). Aortic stenosis was more prevalent in the older cohort (25.6% vs 58.0%; P &lt; 0.01). Operative mortality was acceptable in both groups (1.3% vs 4.3%; P = 0.15). Survival up to 10 years was not statistically different between 2 groups (96.2% vs 91.3% P = 0.16), whereas survival up to 15 years for younger patients was significantly higher (94.9% vs 85.5%; P = 0.03). After non-cardiac related deaths were excluded, survival up to 15 years (98.7% vs 91.3%; P = 0.02) was significantly lower than younger patients. In both groups, survival after the Ross procedure was similar to the age- and sex-matched US population. CONCLUSIONS Survival up to 10 years after Ross procedure were similar, but up to 15 years was significantly higher in younger patients. The Ross procedure restored patients from both groups to expected survival. Our results suggest that at experienced centres, the Ross procedure is a safe and reasonable option for patients who are 50 years and older. The Ross procedure is traditionally offered to young adult patients with expected long-term survival to avoid the potential of early bioprosthetic valve failure and the risk of long-term anticoagulation and shortened life expectancy with mechanical valves [1, 2].</description><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqFkMtLAzEQxoMotlaPXiVHL2vz2N1kj1J8QaEoCt6WNDuxW_ZlHkL9641t1aMwMDPw45tvPoTOKbmipOBTWGvvpvCpKpaTAzSmUvBE8PT1MM6EkkQUKRmhE-fWhJCcM3GMRlykvBBEjtHjInjdt-Bwb7BfAX7qncOD7TVUwQKuOzwoX0PnI9FUYPEHWBcc3vShe4urX6kOZwRvQNktcoqOjGocnO37BL3c3jzP7pP54u5hdj1PNGe5T3jGma4U00oXRhJuKI2lTLXMpORSG2CEMppGm0UqZC7yNOWZkZJmkNHC8Am63OlGs-8BnC_b2mloGtVBH1zJJM-lkAXhEU12qLbxOwumHGzdKrspKSm_Uyy3KZb7FCN_sZcOyxaqX_ontr_bfRj-0foCs6d8pw</recordid><startdate>20231004</startdate><enddate>20231004</enddate><creator>Shih, Emily</creator><creator>Ryan, William H</creator><creator>Squiers, John J</creator><creator>Schaffer, Justin M</creator><creator>Harrington, Katherine B</creator><creator>Banwait, Jasjit K</creator><creator>Meidan, Talia G</creator><creator>DiMaio, J Michael</creator><creator>Brinkman, William T</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6064-5869</orcidid><orcidid>https://orcid.org/0000-0002-2426-513X</orcidid></search><sort><creationdate>20231004</creationdate><title>Outcomes of the Ross procedure in patients older versus younger than 50 years old</title><author>Shih, Emily ; Ryan, William H ; Squiers, John J ; Schaffer, Justin M ; Harrington, Katherine B ; Banwait, Jasjit K ; Meidan, Talia G ; DiMaio, J Michael ; Brinkman, William T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-3532cda2cac9f803f11f11afdb58838cfe20121497094786764435f8815e519f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shih, Emily</creatorcontrib><creatorcontrib>Ryan, William H</creatorcontrib><creatorcontrib>Squiers, John J</creatorcontrib><creatorcontrib>Schaffer, Justin M</creatorcontrib><creatorcontrib>Harrington, Katherine B</creatorcontrib><creatorcontrib>Banwait, Jasjit K</creatorcontrib><creatorcontrib>Meidan, Talia G</creatorcontrib><creatorcontrib>DiMaio, J Michael</creatorcontrib><creatorcontrib>Brinkman, William T</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shih, Emily</au><au>Ryan, William H</au><au>Squiers, John J</au><au>Schaffer, Justin M</au><au>Harrington, Katherine B</au><au>Banwait, Jasjit K</au><au>Meidan, Talia G</au><au>DiMaio, J Michael</au><au>Brinkman, William T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of the Ross procedure in patients older versus younger than 50 years old</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2023-10-04</date><risdate>2023</risdate><volume>64</volume><issue>4</issue><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>Abstract OBJECTIVES The Ross procedure is traditionally considered for young adult patients with aortic valve disease. This study compares long-term outcomes of patients undergoing the Ross procedure who are ≥50 and &lt;50-years old. METHODS Data were collected from 225 patients undergoing Ross procedure at a single centre from 1994 to 2019. Patients were categorized into younger (&lt;50-years old; n = 156) and older (≥50-years old; n = 69) cohorts. Baseline demographics clinical outcomes were compared. RESULTS The mean age was 36 ± 8.1 and 55 ± 4.2 years in the younger and older cohort, respectively. Both groups were predominantly male (58.5% vs 69.6%; P = 0.59). The younger group had a higher rate of aortic insufficiency (51% vs 26.1%; P &lt; 0.01), and bicuspid aortic valve (81.4% vs 58.0%; P &lt; 0.01). Aortic stenosis was more prevalent in the older cohort (25.6% vs 58.0%; P &lt; 0.01). Operative mortality was acceptable in both groups (1.3% vs 4.3%; P = 0.15). Survival up to 10 years was not statistically different between 2 groups (96.2% vs 91.3% P = 0.16), whereas survival up to 15 years for younger patients was significantly higher (94.9% vs 85.5%; P = 0.03). After non-cardiac related deaths were excluded, survival up to 15 years (98.7% vs 91.3%; P = 0.02) was significantly lower than younger patients. In both groups, survival after the Ross procedure was similar to the age- and sex-matched US population. CONCLUSIONS Survival up to 10 years after Ross procedure were similar, but up to 15 years was significantly higher in younger patients. The Ross procedure restored patients from both groups to expected survival. Our results suggest that at experienced centres, the Ross procedure is a safe and reasonable option for patients who are 50 years and older. The Ross procedure is traditionally offered to young adult patients with expected long-term survival to avoid the potential of early bioprosthetic valve failure and the risk of long-term anticoagulation and shortened life expectancy with mechanical valves [1, 2].</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>37439708</pmid><doi>10.1093/ejcts/ezad260</doi><orcidid>https://orcid.org/0000-0002-6064-5869</orcidid><orcidid>https://orcid.org/0000-0002-2426-513X</orcidid></addata></record>
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title Outcomes of the Ross procedure in patients older versus younger than 50 years old
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