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The Landscape of Congenital Heart Disease Treated with the Ross Procedure.
Bojko, Markian M; Wiggins, Luke; Cleveland, John D; Bagrodia, Neelesh; Elsayed, Ramsey S; Cleveland, David C; Starnes, Vaughn A.
Afiliación
  • Bojko MM; Heart Institute, Children's Hospital of Los Angeles, Los Angeles, California.
  • Wiggins L; Heart Institute, Children's Hospital of Los Angeles, Los Angeles, California.
  • Cleveland JD; Heart Institute, Children's Hospital of Los Angeles, Los Angeles, California.
  • Bagrodia N; Heart Institute, Children's Hospital of Los Angeles, Los Angeles, California.
  • Elsayed RS; Department of Surgery, Southwest Healthcare MEC, Temecula, California.
  • Cleveland DC; Heart Institute, Children's Hospital of Los Angeles, Los Angeles, California.
  • Starnes VA; Heart Institute, Children's Hospital of Los Angeles, Los Angeles, California.
J Thorac Cardiovasc Surg ; 2024 Sep 09.
Article en En | MEDLINE | ID: mdl-39260598
ABSTRACT

OBJECTIVES:

The Ross procedure has excellent outcomes in the pediatric population. Some series report age and anatomy dependent outcomes, but no comprehensive analysis stratified by these variables exists. We sought to describe the landscape of congenital heart disease (CHD) treated with the Ross procedure and identify the patients best served with this operation.

METHODS:

Over 30 years, 317 pediatric patients underwent the Ross procedure. Patients were stratified into 4 age groups neonates (<31days,n=21), infants (31days-1year,n=40), children (1-12years,n=165), and adolescents (13-18years,n=91), and 3 anatomical groups isolated aortic valve (AV) disease (n=221), Shone's complex or multilevel LVOT obstruction (n=61), and complex CHD (n=35). Groups were compared across outcomes.

RESULTS:

Neonates and infants had the highest rates of Shone's syndrome (p<0.001), complex CHD (p<0.001), concomitant root enlargement (p<0.001), and arch procedures (p<0.001). Operative mortality and morbidity were 14/317 (4.4%) and 44/317 (14%) respectively. Both were higher in neonates and infants (p<0.001,p<0.001), but lower for patients with isolated AV disease (p<0.001,p<0.001). 10-year survival and freedom from LVOT reintervention were 92% and 81% and were both significantly better in patients with isolated AV disease compared to those with complex CHD (p<0.001,p=0.005). In neonates and infants with isolated AV disease, operative mortality was 1/23 (4%), morbidity was 2/23 (9%), 10-year survival was 85.6%, and 10-year freedom from LVOT reintervention was 88.4%.

CONCLUSIONS:

Among pediatric patients, those with isolated AV disease are best served with the Ross procedure, regardless of age. Complex CHD is associated with lower survival and increased risk of LVOT reintervention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos