부산대학교 도서관

Key Words Ross procedure; survival; age difference; hemodynamics Abstract Background The Ross procedure offers several advantages in nonelderly adults; however, the optimal age cutoff remains undetermined. The aim of this study was to compare the safety and mid-term outcomes after the Ross procedure in adult patients age [less than or equal to]50 years and those age >50 years. Methods Between 2011 and 2019, 497 consecutive patients (mean age, 47 [plus or minus] 12 years; 73% male) underwent a Ross procedure in 5 Canadian centers and were followed prospectively. Of these patients, 232 (47%) were age >50 years (mean, 57 [plus or minus] 4 years) and 265 (53%) were age [less than or equal to]50 years (mean, 38 [plus or minus] 10 years). Early and mid-term outcomes were compared between the 2 groups. Results Patients age >50 years had more comorbidities: diabetes (14% vs 4%; P < .01), chronic obstructive pulmonary disease (8% vs 2%; P < .01), and coronary artery disease (17% vs 3%; P < .01). In contrast, patients age [less than or equal to]50 years had more redo surgeries (24% vs 8%; P < .01), pure aortic regurgitation (21% vs 6%; P < .01) and unicuspid valves (42% vs 9%; P 50 years: 0.7 [plus or minus] 0.7%; [less than or equal to]50 years: 4 [plus or minus] 2%; P = .12). Survival at 6 years was 98 [plus or minus] 2% in patient age >50 years versus 96 [plus or minus] 2% in those age [less than or equal to]50 years (P = .43), similar to the age- and sex-matched general population. Conclusions The Ross procedure is a safe operation in patients age >50 years and provides excellent hemodynamics, stable valve function, and restored survival at mid-term follow-up. In expert centers, it should be considered as an alternative in selected patients age >50 years. Abbreviations and Acronyms AR, aortic regurgitation; AS, aortic stenosis; AV, aortic valve; AVR, aortic valve replacement; LV, left ventricular; PPM, patient--prosthesis mismatch; TAVR, transcatheter aortic valve replacement; ViV, valve in valve Author Affiliation: (a) Department of Cardiac Surgery, Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada (b) Department of Cardiac Surgery, London Health Science Center, Western University, London, Ontario, Canada (c) Department of Cardiac Surgery, Royal Columbian Hospital, University of British Columbia, Vancouver, British Columbia, Canada (d) Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio (e) Department of Cardiovascular Surgery, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY * Address for reprints: Ismail El-Hamamsy, MD, PhD, Department of Cardiovascular Surgery, Mount Sinai Hospital, 1190, Fifth Ave, New York, NY 10029. Article History: Received 17 April 2020; Revised 18 August 2020; Accepted 25 September 2020 (footnote) Accepted for oral presentation at the 100th Annual Meeting of The American Association for Thoracic Surgery, New York, NY, April 25-28, 2020 (footnote)* Individual members of the Canadian Ross Registry who contributed to this study include Laurence Lefebvre, Nancy Poirier, Raymond Cartier, Philippe Demers (Montreal Heart Institute, Montreal, Canada), and Mohamed Abdel Halim (Centre Hospitalier de l'Universite de Sherbrooke, Quebec, Canada). Byline: Vincent Chauvette, MD (a), Ismail Bouhout, MD, PhD(c) (a), Mohammed Tarabzoni, MD (b), Daniel Wong, MD, PHM (c), John Bozinovski, MD (d), Michael W.A. Chu, MD, MEd (b), Ismail El-Hamamsy, MD, PhD [ismail.el-hamamsy@mountsinai.org] (a,e,*), Laurence Lefebvre, Nancy Poirier, Raymond Cartier, Philippe Demers, Mohamed Abdel Halim