Valentin Loobuyck1, Jerome Soquet2, Mouhamed Djahoum Moussa2, Augustin Coisne3, Claire Pinçon4, Marjorie Richardson3, Natacha Rousse2, Agnès Mugnier5, Francis Juthier2, Sylvestre Marechaux6, Alain Prat5, André Vincentelli2. 1. Department of cardiac surgery, Institut Coeur Poumon, CHU Lille, Lille, France; Inserm U1011, Institut Pasteur de Lille, Université de Lille, Lille, France. Electronic address: v.loobuyck@gmail.com. 2. Department of cardiac surgery, Institut Coeur Poumon, CHU Lille, Lille, France; Inserm U1011, Institut Pasteur de Lille, Université de Lille, Lille, France. 3. Department of echocardiography, Institut Coeur Poumon, CHU Lille, Lille, France. 4. Department of biostatistics, Université de Lille, Lille, France. 5. Department of cardiac surgery, Institut Coeur Poumon, CHU Lille, Lille, France. 6. Department of Cardiology and Heart Valve Center, Groupement des Hôpitaux de l'Institut Catholique de Lille, Faculté libre de médecine, Lulle, France.
Abstract
BACKGROUND: The best valvular substitute remains controversial in young adults with active aortic valve endocarditis. Ross procedure has gained interest because of its theoretical resistance to infection. We aimed to report our long-term outcomes of the Ross procedure in this indication. METHODS: Between March 1992 and January 2019, 511 patients underwent a Ross procedure in our institution. Among them, we included 38 patients who suffered from an active aortic valve infective endocarditis. The mean age was 33.9 ± 8.1 years. Six patients had emergent procedures, 17 patients had perivalvular involvement. Pulmonary autograft was implanted using the full root technique in 78.9% of patients. Median follow-up was 12 years (IQR [1.75 - 16.25]). RESULTS: The hospital mortality rate was 5.3%. Estimated overall survival was 84.2 ± 6.6% at 10 years. There were two cases of recurrent endocarditis, both requiring reoperation. Six other patients required reoperation on autograft and/or homograft. Estimated freedom from recurrent endocarditis or reoperation was 89.4 ± 5.9% at 10 years. CONCLUSIONS: In experienced centers, Ross procedure is a reliable alternative to prosthetic or homograft valve replacement in young adults suffering from active aortic valve endocarditis, with a low operative risk and good long-term results.
BACKGROUND: The best valvular substitute remains controversial in young adults with active aortic valve endocarditis. Ross procedure has gained interest because of its theoretical resistance to infection. We aimed to report our long-term outcomes of the Ross procedure in this indication. METHODS: Between March 1992 and January 2019, 511 patients underwent a Ross procedure in our institution. Among them, we included 38 patients who suffered from an active aortic valve infective endocarditis. The mean age was 33.9 ± 8.1 years. Six patients had emergent procedures, 17 patients had perivalvular involvement. Pulmonary autograft was implanted using the full root technique in 78.9% of patients. Median follow-up was 12 years (IQR [1.75 - 16.25]). RESULTS: The hospital mortality rate was 5.3%. Estimated overall survival was 84.2 ± 6.6% at 10 years. There were two cases of recurrent endocarditis, both requiring reoperation. Six other patients required reoperation on autograft and/or homograft. Estimated freedom from recurrent endocarditis or reoperation was 89.4 ± 5.9% at 10 years. CONCLUSIONS: In experienced centers, Ross procedure is a reliable alternative to prosthetic or homograft valve replacement in young adults suffering from active aortic valve endocarditis, with a low operative risk and good long-term results.
Authors: Campbell D Flynn; Joshua H De Bono; Benjamin Muston; Nivedita Rattan; David H Tian; Marco Larobina; Michael O'Keefe; Peter Skillington Journal: Ann Cardiothorac Surg Date: 2021-07