title: Outcomes and Short-Term Follow-Up in Complex Ross Operations in Pediatric Patients Undergoing Damus-Kaye-Stansel Takedown.
abstract: Review echocardiography and outcomes before and after Ross procedures, including patients undergoing biventricular conversion with Damus-Kaye-Stansel (DKS) takedown. A retrospective review was performed on 62 patients undergoing simple (control group) and complex Ross procedures, including 12 patients who underwent biventricular conversion with Ross operation and DKS takedown (complex). Echocardiography was reviewed preoperatively and at discharge and late follow-up. Kaplan-Meier estimates of patient survival and freedom from reintervention were obtained. In all, 62 patients had a median age of 4.5 years (interquartile range [IQR]: 1-12.5), weight of 16.4kg (IQR: 8-41), and follow-up of 3.8 years (IQR: 1.3-6). The complex DKS takedown group had 2 deaths, no neoaortic valve or root reinterventions, and 3 right ventricular outflow tract (VOT) reinterventions. There were no differences from the control group in left VOT or right VOT reinterventions. Neither group showed differences between pre- and late follow-up aortic root and ascending aorta dimensions, and no correlations were found among preoperative pulmonary valve (PV) size, late aortic regurgitation (AR), aortic root, or ascending aortic Z-scores. Aortic valve size increased from discharge to late follow-up for both groups (P ≤ .05); 90% of patients at late follow-up had mild or less AR with similar distributions in severity between complex and control groups. Severity of late AR showed no correlation with preoperative PV size and is independent of it. The Ross procedure has good short-term results in simple and complex patients and should be considered in those undergoing Ross operation with biventricular conversion and DKS takedown. Moreover, native PV size should not be a contraindication for Ross procedure.
authors: Department of Cardiac Surgery, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Christopher W
authors: CW
authors: Baird
authors: Department of Anesthesia, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: David
authors: D
authors: Zurakowski
authors: Department of Cardiac Surgery, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Alejandra
authors: A
authors: Bueno
authors: Department of Cardiac Surgery, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Michele J
authors: MJ
authors: Borisuk
authors: Department of Cardiac Surgery, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Vijayakumar
authors: V
authors: Raju
authors: Department of Cardiac Surgery, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Suyog A
authors: SA
authors: Mokashi
authors: Department of Cardiac Surgery, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Sitaram
authors: S
authors: Emani
authors: Department of Cardiology, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Gerald R
authors: GR
authors: Marx
authors: Department of Cardiac Surgery, Boston Children׳s Hospital & Harvard Medical School, Boston, Massachusetts.
authors: Pedro J
authors: PJ
authors: Del Nido
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006351:Heart Valves / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies; D055815:Young Adult
keywords: Damus-Kaye stanzel procedure; Ross procedure; autologous; biventricular repair