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Central Surgical Association

49th Annual Meeting

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Aortic reinterventions in patients >13 years old after the Ross procedure
Carlos E. Diaz1, *Melita Viegas1, Jordann Lewis2, Kristian Punu2, Mario Castro-Medina1, Victor Morell1
1Cardiothoracic Surgery, Children's Hospital of Pittsburh - UPMC, Pittsburgh, Pennsylvania, United States, 2University of Pittsburgh, Pittsburgh, Pennsylvania, United States

Objective: To assess intermediate outcomes among patients older than 13 years old who underwent a Ross procedure at a single center and to describe the relationship of external reinforcement with the need for aortic reinterventions
Methods: Retrospective analysis of single-center clinical records from 2005 to 2020. Comparative analysis of baseline and perioperative variables was done using a non-parametric test between the Ross procedure and the reinforced Ross procedure. Kaplan Meier function was used to assed the survival free from aortic reintervention.
Results: A total of 40 patients with a median age of 17.9 years (IQR 15.4 – 20.1), 88% (n= 35) males, and a median weight of 64.1 Kg (IQR 55.8-83.2) were included, where 15% (n= 6) had a Ross-Konno procedure and 85% (n= 34) a Ross procedure. Overall, 70% (n= 28) of the patients had the pulmonary autograft reinforced within a woven vascular graft, with a median size of 28 mm (IQR 26 – 28). The most common indication for surgery was a mixed stenotic/insufficiency lesion in 75% (n=10) of the cases, and the most common anatomic configuration was a bicuspid valve in 73% (n= 29); 65% (n= 26) of the patients had had a pre-Ross aortic intervention. No differences were observed between the reinforced and non-reinforced group in terms of age (16 vs 18 years: p=0.29), and weight (63 vs. 69 kg; p=0.57) nor indication for surgery (Table 1). After a median follow-up time of 5.1 years (IQR 2.6 – 7.8), 25% (n=3) of the non-reinforced Ross had required aortic reinterventions compared to 4% (n=1) within the reinforced group.
Conclusion: Intermediate outcomes after the Ross procedure in patients >13 years old are favorable with externally reinforced pulmonary autograft.


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