Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registry
BackgroundUnicuspid aortic valve (UAV) is the second most common underlying cause of aortic valve dysfunction in young adults after the bicuspid valve. The valve may be replaced (for example by pulmonary autograft) or repaired using the bicuspidization technique. The aim of our study was to compare...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.900426/full |
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| author | Ján Gofus Mikita Karalko Petr Fila Petr Fila Jiří Ondrášek Hans-Joachim Schäfers Adrian Kolesár Emmanuel Lansac Ismail El-Hamamsy Laurent de Kerchove Christian Dinges Jaroslav Hlubocký Petr Němec Petr Němec Martin Tuna Jan Vojáček |
| author_facet | Ján Gofus Mikita Karalko Petr Fila Petr Fila Jiří Ondrášek Hans-Joachim Schäfers Adrian Kolesár Emmanuel Lansac Ismail El-Hamamsy Laurent de Kerchove Christian Dinges Jaroslav Hlubocký Petr Němec Petr Němec Martin Tuna Jan Vojáček |
| author_sort | Ján Gofus |
| collection | DOAJ |
| description | BackgroundUnicuspid aortic valve (UAV) is the second most common underlying cause of aortic valve dysfunction in young adults after the bicuspid valve. The valve may be replaced (for example by pulmonary autograft) or repaired using the bicuspidization technique. The aim of our study was to compare short- and mid-term outcomes of Ross procedure with bicuspidization in patients with severe UAV dysfunction.MethodsThis was a multi-center retrospective observational cohort study comparing data from two dedicated Ross centers in the Czech Republic with bicuspidization outcomes provided by AVIATOR registry. As for the Ross group, only the patients with UAV were included. Primary endpoint was mid-term freedom from reintervention. Secondary endpoints were mid-term freedom from major adverse events, endocarditis and pacemaker implantation.ResultsThroughout the study period, 114 patients underwent the Ross procedure (years 2009-2020) and 126 patients underwent bicuspidization (years 2006-2019). The bicuspidization group was significantly younger and presented with a higher degree of dyspnea, a lower degree of aortic valve stenosis and more often with pure regurgitation. The primary endpoint occurred more frequently in the bicuspidization group than in the Ross group – 77.9 vs. 97.9 % at 5 years and 68.4 vs. 75.2 % at 10 years (p < 0.001). There was no difference in secondary endpoints.ConclusionRoss procedure might offer a significantly lower mid-term risk of reintervention than bicuspidization in patients with UAV. Both procedures have comparable survival and risk of other short- and mid-term complications postoperatively. |
| first_indexed | 2024-12-10T11:39:28Z |
| format | Article |
| id | doaj.art-7376b59c3a7a4d4fa0f1880ad6e22cdb |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-10T11:39:28Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-7376b59c3a7a4d4fa0f1880ad6e22cdb2022-12-22T01:50:19ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.900426900426Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registryJán Gofus0Mikita Karalko1Petr Fila2Petr Fila3Jiří Ondrášek4Hans-Joachim Schäfers5Adrian Kolesár6Emmanuel Lansac7Ismail El-Hamamsy8Laurent de Kerchove9Christian Dinges10Jaroslav Hlubocký11Petr Němec12Petr Němec13Martin Tuna14Jan Vojáček15Department of Cardiac Surgery, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove and Charles University, Hradec Kralove, CzechiaDepartment of Cardiac Surgery, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove and Charles University, Hradec Kralove, CzechiaDepartment of Cardiac Surgery and Transplantation Brno, Faculty of Medicine, Masaryk University, Brno, CzechiaCentre of Cardiovascular Surgery and Transplantation, Brno, CzechiaCentre of Cardiovascular Surgery and Transplantation, Brno, CzechiaSaarland University Medical Center, Homburg, GermanyEast Slovakian Institute for Cardiac and Vascular Diseases, Košice, SlovakiaInstitut Mutualiste Montsouris, Paris, FranceMount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, United StatesCliniques Universitaires Saint-Luc, Bruxelles, BelgiumLandeskrankenhaus Salzburg, Salzburg, Austria0Department of Cardiovascular Surgery, General University Hospital, Prague, CzechiaDepartment of Cardiac Surgery and Transplantation Brno, Faculty of Medicine, Masaryk University, Brno, CzechiaCentre of Cardiovascular Surgery and Transplantation, Brno, CzechiaDepartment of Cardiac Surgery, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove and Charles University, Hradec Kralove, CzechiaDepartment of Cardiac Surgery, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove and Charles University, Hradec Kralove, CzechiaBackgroundUnicuspid aortic valve (UAV) is the second most common underlying cause of aortic valve dysfunction in young adults after the bicuspid valve. The valve may be replaced (for example by pulmonary autograft) or repaired using the bicuspidization technique. The aim of our study was to compare short- and mid-term outcomes of Ross procedure with bicuspidization in patients with severe UAV dysfunction.MethodsThis was a multi-center retrospective observational cohort study comparing data from two dedicated Ross centers in the Czech Republic with bicuspidization outcomes provided by AVIATOR registry. As for the Ross group, only the patients with UAV were included. Primary endpoint was mid-term freedom from reintervention. Secondary endpoints were mid-term freedom from major adverse events, endocarditis and pacemaker implantation.ResultsThroughout the study period, 114 patients underwent the Ross procedure (years 2009-2020) and 126 patients underwent bicuspidization (years 2006-2019). The bicuspidization group was significantly younger and presented with a higher degree of dyspnea, a lower degree of aortic valve stenosis and more often with pure regurgitation. The primary endpoint occurred more frequently in the bicuspidization group than in the Ross group – 77.9 vs. 97.9 % at 5 years and 68.4 vs. 75.2 % at 10 years (p < 0.001). There was no difference in secondary endpoints.ConclusionRoss procedure might offer a significantly lower mid-term risk of reintervention than bicuspidization in patients with UAV. Both procedures have comparable survival and risk of other short- and mid-term complications postoperatively.https://www.frontiersin.org/articles/10.3389/fcvm.2022.900426/fullRoss procedurebicuspidizationreinterventionunicuspid aortic valveaortic valve reconstruction 2 |
| spellingShingle | Ján Gofus Mikita Karalko Petr Fila Petr Fila Jiří Ondrášek Hans-Joachim Schäfers Adrian Kolesár Emmanuel Lansac Ismail El-Hamamsy Laurent de Kerchove Christian Dinges Jaroslav Hlubocký Petr Němec Petr Němec Martin Tuna Jan Vojáček Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registry Frontiers in Cardiovascular Medicine Ross procedure bicuspidization reintervention unicuspid aortic valve aortic valve reconstruction 2 |
| title | Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registry |
| title_full | Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registry |
| title_fullStr | Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registry |
| title_full_unstemmed | Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registry |
| title_short | Comparison of bicuspidization and Ross procedure in the treatment of unicuspid aortic valve disease in adults – Insight from the AVIATOR registry |
| title_sort | comparison of bicuspidization and ross procedure in the treatment of unicuspid aortic valve disease in adults insight from the aviator registry |
| topic | Ross procedure bicuspidization reintervention unicuspid aortic valve aortic valve reconstruction 2 |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.900426/full |
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