Abstract 15799: Autograft External Support is Associated With Fewer Aortic Reinterventions in Patients >13 Years Old After the Ross Procedure

Abstract

Objective: To assess intermediate outcomes among patients older than 13 years old who underwent a Ross procedure at a single center and to describe the relationship of external reinforcement with the need for aortic reinterventions Methods: Retrospective analysis of a single center clinical records from 2005 to 2020. Comparative analysis of baseline and perioperative variables was done using non-parametric test between Ross procedure and modified Ross procedure. Kaplan Meier function was used to evaluate the survival free from aortic reintervention. Results: A total of 40 patients with a median age of 17.9 years (IQR 15.4 - 20.1), 88% (n= 35) males and median weight of 64.1 Kg (IQR 55.8-83.2) were included, where 15% (n= 6) had a Ross-Konno procedure and 85% (n= 34) a Ross procedure. Overall, 70% (n= 28) of the patients had the pulmonary autograft reinforced with a woven vascular graft, with a median size of 28 mm (IQR 26 - 28). The most common indication for surgery was a mixed stenotic/insufficiency lesion in 75% (n=10) of cases, and the most common anatomic configuration was a bicuspid valve in 73% (n= 29); 65% (n= 26) of the patients had had a pre-Ross aortic intervention. No differences were observed between the reinforced and non-reinforce group in terms of age (16 vs 18 years: p=0.29), and weight (63 vs. 69 kg; p=0.57) nor indication for surgery (Table 1). After a median follow up time of 5.1 years (IQR 2.6 - 7.8), 25% (n=3) of the non-reinforced Ross had required aortic reinterventions compared to 4% (n=1) with the reinforced group. The survival free from aortic reintervention at 5 years was 96% (CI 87 - 99) in the cohort, without differences in the Kaplan Meier curves between the 2 groups (log rank= 0.18) Conclusion: Intermediate outcomes after the Ross procedure in patients >13 years old are favorable, with a lower rate of reintervention in patients with a reinforced autograft. Long term outcomes are needed to further elucidate the greater impact of external support of valve competency.