Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Cardiology. https://doi.org/10.1001/jamacardio.2023.4090 Maximiliaan L. Notenboom et al.
Points
- The Ross procedure, a treatment for aortic valve disease (AVD) in adults, has gained renewed interest.
- A study evaluated the long-term outcomes of the Ross procedure in adults with AVD through a post hoc analysis of a randomized clinical trial.
- The study included 108 adult patients with a median age of 38 years and a median follow-up duration of 24.1 years.
- The Ross procedure showed excellent long-term survival rates comparable to the general population, with a 25-year survival rate of 83.0%.
- The procedure also demonstrated durable outcomes with a relatively low need for reintervention, making it a viable treatment option for AVD in late adulthood.
Summary
The Ross procedure, a treatment for adults with aortic valve disease (AVD), has gained renewed interest. This study aimed to assess the Ross procedure’s long-term clinical and echocardiographic outcomes in adults with AVD. The study conducted a post hoc analysis of a randomized clinical trial, including adult patients who underwent the Ross procedure for AVD treatment. Data from the trial between 1994 and 2001 and retrospective data collected after 2010 were analyzed.
The study included 108 predominantly male adults with a median age of 38. The median duration of clinical follow-up was 24.1 years, with a high follow-up completeness rate of 98%. The primary endpoint of long-term survival showed a 25-year survival rate of 83.0%, comparable to the general population. Freedom from reintervention at 25 years was observed in 71.1% of patients, with lower rates for autograft and homograft reinterventions. The study also reported low perioperative mortality and favorable 10-year survival after reoperation.
In conclusion, the study demonstrated that the Ross procedure provided excellent long-term survival rates comparable to the general population. The procedure also showed durable outcomes with a relatively low need for reintervention. However, a progressive functional decline was observed over time. These findings suggest that the Ross procedure can be a viable treatment option for AVD in late adulthood, offering sustained benefits and improved quality of life.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24064
References Notenboom, M. L., Melina, G., Veen, K. M., De Robertis, F., Coppola, G., De Siena, P., Navarra, E. M., Gaer, J., Ibrahim, M. E. K., El-Hamamsy, I., Takkenberg, J. J. M., & Yacoub, M. H. (2023). Long-Term Clinical and Echocardiographic Outcomes Following the Ross Procedure: A Post Hoc Analysis of a Randomized Clinical Trial. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2023.4090
