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Perioperative and Long-Term Outcomes of Ross versus Mechanical Aortic Valve Replacement
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  • Chelsea Wenos,
  • Jeremy Herrmann,
  • Lava Timsina,
  • Parth M. Patel,
  • John W. Fehrenbacher,
  • John Brown
Chelsea Wenos
Indiana University Department of Surgery

Corresponding Author:[email protected]

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Jeremy Herrmann
Indiana University Department of Surgery
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Lava Timsina
Indiana University Department of Surgery
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Parth M. Patel
Indiana University Department of Surgery
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John W. Fehrenbacher
Indiana University Department of Surgery
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John Brown
Indiana University Department of Surgery
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Background The ideal aortic valve replacement strategy in young- and middle-aged adults remains up for debate. Clinical practice guidelines recommend mechanical prostheses for most patients less than 50 years of age undergoing aortic valve replacement. However, risks of major hemorrhage and thromboembolism associated with long-term anticoagulation may make the pulmonary autograft technique, or Ross procedure, a preferred approach in select patients. Methods Data were retrospectively collected for patients 18 to 50 years of age who underwent either the Ross procedure or mechanical aortic valve replacement (mAVR) between January 2000 and December 2016 at a single institution. Propensity score matching was performed and yielded 32 well-matched pairs from a total of 216 eligible patients. Results Demographic and preoperative characteristics were similar between the two groups. Median follow-up was 7.3 and 6.9 years for Ross and mAVR, respectively. There were no early mortalities in either group and no statistically significant differences were observed with respect to perioperative outcomes or complications. Major hemorrhage and stroke events were significantly more frequent in the mAVR population ( p < 0.01). Overall survival ( p = 0.93), freedom from reintervention and valve dysfunction free survival ( p = 0.91) were equivalent. Conclusions In this mid-term propensity score-matched analysis, the Ross procedure offers similar perioperative outcomes, freedom from reintervention or valve dysfunction as well as overall survival compared to traditional mAVR but without the morbidity associated with long-term anticoagulation. At specialized centers with sufficient expertise, the Ross procedure should be strongly considered in select patients requiring aortic valve replacement.
27 Oct 2021Submitted to Journal of Cardiac Surgery
01 Nov 2021Submission Checks Completed
01 Nov 2021Assigned to Editor
08 Nov 2021Reviewer(s) Assigned
21 Nov 2021Review(s) Completed, Editorial Evaluation Pending
28 Nov 2021Editorial Decision: Revise Major
17 Jan 20221st Revision Received
17 Jan 2022Assigned to Editor
17 Jan 2022Submission Checks Completed
17 Jan 2022Reviewer(s) Assigned
23 Jan 2022Review(s) Completed, Editorial Evaluation Pending
02 Feb 2022Editorial Decision: Revise Minor
25 Mar 20222nd Revision Received
25 Mar 2022Submission Checks Completed
25 Mar 2022Assigned to Editor
25 Mar 2022Reviewer(s) Assigned
30 Mar 2022Review(s) Completed, Editorial Evaluation Pending
01 Apr 2022Editorial Decision: Accept
Oct 2022Published in Journal of Cardiac Surgery volume 37 issue 10 on pages 2963-2971. 10.1111/jocs.16831