Improved Survival After the Ross Procedure Compared With Mechanical Aortic Valve Replacement

Buratto, Edward; Shi, William Y.; Wynne, Rochelle; Poh, Chin; Larobina, Marco; O’Keefe, Michael; Goldblatt, John; Tatoulis, James; Skillington, Peter

doi:10.1016/j.jacc.2018.01.048

Cited by 114 publications

(87 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The advantages are related to the somatic growth of the cardiovascular structures and with the avoidance of anticoagulants that would be required lifelong in the case of conventional mechanical prostheses [ 14 , 15 , 16 , 17 , 18 ]. However, the incidence of pulmonary autograft (PA) expansion reported after Ross operation, without loss of integrity of the valve leaflets, varies from 20% to 40%, and reoperation is not uncommon [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Finite Element Analysis Investigate Pulmonary Autograft Root and Leaflet Stresses to Understand Late Durability of Ross Operation

et al. 2020

View full text Add to dashboard Cite

Ross operation might be a valid option for congenital and acquired left ventricular outflow tract disease in selected cases. As the pulmonary autograft is a living substitute for the aortic root that bioinspired the Ross operation, we have created an experimental animal model in which the vital capacity of the pulmonary autograft (PA) has been studied during physiological growth. The present study aims to determine any increased stresses in PA root and leaflet compared to the similar components of the native aorta. An animal model and a mathematical analysis using finite element analysis have been used for the purpose of this manuscript. The results of this study advance our understanding of the relative benefits of pulmonary autograft for the management of severe aortic valve disease. However, it launches a warning about the importance of the choice of the length of the conduits as mechanical deformation, and, therefore, potential failure, increases with the length of the segment subjected to stress. Understanding PA root and leaflet stresses is the first step toward understanding PA durability and the regions prone to dilatation, ultimately to refine the best implant technique.

show abstract

Section: Introductionmentioning

confidence: 99%

Finite Element Analysis Investigate Pulmonary Autograft Root and Leaflet Stresses to Understand Late Durability of Ross Operation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In turn, a pulmonary allograft is then placed in the pulmonic position. Australian data have demonstrated superior long‐term survival with the Ross Procedure compared with mechanical prosthesis in specialised centres …”

Section: Evidencementioning

confidence: 99%

Contemporary review of severe aortic stenosis

Adams

Ashokkumar

Newcomb

et al. 2019

Internal Medicine Journal

View full text Add to dashboard Cite

Severe aortic stenosis (AS) is the most common form of valvular heart disease in the developed world with a rising prevalence due to an ageing Australian population. Transcatheter aortic valve implantation (TAVI) offers a less invasive option for the treatment of severe AS with evidence supporting of TAVI compared to medical therapy in inoperable patients, and superior to surgical aortic valve replacement (SAVR) in high-risk patients. Equal outcomes have been observed in all-comer intermediate risk populations. The Heart Team utilises a shared decision-making approach between physicians and surgeons in risk stratifying patients and reduces the intrinsic bias that may occur if decisions are made in isolation. Geriatric assessment is useful in identifying pre-operative frailty, a major risk factor for death post aortic valve intervention. In severe AS, a decision can be made collaboratively to pursue TAVI, SAVR, a Ross Procedure, or conservative management. The learning curve associated with TAVI has improved markedly with overall complication rates decreasing around the world. Contemporary changes in practice such as conscious sedation without general anaesthesia, expedited recovery and early discharge will likely improve cost-effectiveness. In 2018, TAVI is a well-established procedure in Australia that has revolutionised the management of severe AS. In the future with an expanding elderly population, the number of patients to benefit from transcatheter therapies for severe AS is hypothesised to increase 4-10 fold. Heart Team assessment is crucial in patients with severe AS to direct appropriate management. This article is protected by copyright. All rights reserved.

show abstract

“…2,3 Recent evidence suggest that patients undergoing the Ross procedure may even have better long-term survival than those undergoing mechanical AVR. 4 Several important studies have been published in the last few years demonstrating very good to excellent long-term results of the Ross procedure in large series of young adult patients needing AVR. [2][3][4][5] Despite these findings, the Ross operation has not gained widespread acceptance, and published valve guidelines have generally not been supportive of the procedure.…”

mentioning

confidence: 99%

“…4 Several important studies have been published in the last few years demonstrating very good to excellent long-term results of the Ross procedure in large series of young adult patients needing AVR. [2][3][4][5] Despite these findings, the Ross operation has not gained widespread acceptance, and published valve guidelines have generally not been supportive of the procedure. The latest American guidelines give a class IIb, level of evidence C recommendation for the Ross procedure in young patients when vitamin K anticoagulation is contraindicated or undesirable, 6 and the most recent European guidelines 7 do not even mention the Ross operation whatsoever.…”

mentioning

confidence: 99%