title: Autograft failure during follow-up after the Ross procedure: predictive factors in a prospective series.
abstract: To determine the incidence of, and predictive factors for, aortic autograft failure during follow-up after the Ross procedure. Of 102 consecutive patients who underwent surgery at our centre between 1997 and 2009, we selected 83 (age 32+/-11 years), all of whom had been discharged without significant autograft regurgitation and for whom at least one follow-up echocardiogram was available. Autograft failure was defined as the presence of at least moderate regurgitation on echocardiography. After a median follow-up period of 4.2 years (range 0.2-10.9 years), eight patients (9.6%) developed this complication, three of whom required valve replacement. The probability of survival without autograft failure at 5 years was 90% (95% confidence interval [CI] 83%-98%). Multivariate analysis showed that undergoing surgery during the first 6 months of the learning curve (hazard ratio = 9.1; 95% CI, 1.4-59.4; P=.021) and a large pulmonary annulus size, normalized by body surface area, (hazard ratio = 1.4; 95% CI, 1.016-1.924; P=.04) were independent predictors of this complication.
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Córdoba, España. maruor@gmail.com
authors.forename: Martín
authors.initials: M
authors.lastname: Ruiz Ortiz
authors.forename: Mónica
authors.initials: M
authors.lastname: Delgado
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa
authors.forename: Elías
authors.initials: E
authors.lastname: Romo
authors.forename: Jaime
authors.initials: J
authors.lastname: Casares
authors.forename: Pedro
authors.initials: P
authors.lastname: Alados
authors.forename: Ignacio
authors.initials: I
authors.lastname: Muñoz
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D011446:Prospective Studies; D011664:Pulmonary Valve / Q000637:transplantation*; D017211:Treatment Failure