The Ross Operation in Children and Young Adults: 12-Year Results and Trends From the UK National Database. (July 2014)

• Record Type: Journal Article
• Authors: Zebele, Carlo; Chivasso, Pierpaolo; Sedmakov, Christo; Angelini, Gianni; Caputo, Massimo; Parry, Andrew; Stoica, Serban
• Is Part Of: World journal for pediatric & congenital heart surgery. Volume 5:Number 3(2014:Jul.)
• Page Start: 406
• Page End: 412
• Publication Date: 2014-07
• Subjects: Ross operation -- aortic valve -- replacement -- heart valve -- autograft -- outcomes (includes mortality -- morbidity); Pediatric cardiology -- Periodicals; Congenital heart disease in children -- Periodicals; Heart -- Abnormalities -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Heart Defects, Congenital -- surgery -- Periodicals; Cardiac Surgical Procedures -- Periodicals; Child -- Periodicals; Adult -- Periodicals; 618.9212
• DOI: 10.1177/2150135114537532
• Languages: English
• ISSNs: 2150-1351

Abstract

Objectives: To determine UK national trends and results of the Ross operation in relation to all aortic valve interventions. Methods: Examination of the UK Congenital Central Cardiac Audit Database for all aortic valve procedures performed between 2000 and 2011 in children (0-16 years) and young adults (16-30 years). Results: A total of 2, 206 aortic valve procedures were performed in children and 1, 824 in young adults, the proportions in the two groups being: Ross operation (19% vs 15%, respectively), surgical valvoplasty (9.5% vs 4%), surgical valvotomy (9.5% vs 1%), aortic valve replacement (AVR; 11% vs 55%), aortic root replacement (4% vs 18%), and balloon valvoplasty (47% vs 7%). The 30-day and 1-year survival after Ross is 99.3% and 98.7%, respectively, in the last four years achieving 100%. In children, the proportion of balloon valvoplasty increased from an average of 43% in 2000 to 2006 to 53% in 2007 to 2011, whereas the Ross operation decreased from 22% to 16% ( P < .001). In young adults, the figures are an increase from 49% to 58% for AVR compared to a decrease from 23% to 9% for Ross ( P < .001). Our own single-center series of 91 patients also shows standard results for early- and long-term survival and freedom from reoperation, but gradually fewer Ross operations performed. The year-on-year changes show a significant decreasing trend locally and nationally. Conclusions: Despite an excellent track record, the Ross operation is performed less frequently in the United Kingdom. This report is a first step in comparing treatment modalities at national level.