272 * DOES THE ROSS PROCEDURE PROVIDE THE BEST BIOLOGICAL OPTION IN YOUNG ADULTS WITH SEVERE AORTIC STENOSIS? QUEBEC CITY EXPERIENCE WITH 20-YEAR FOLLOW-UP
Bibliographic record
Abstract
Objectives: The optimal prosthesis option for aortic valve replacement (AVR) in adult patients less than 60 years of age with aortic stenosis remains controversial. Our objective was to determine the long-term outcomes of the Ross procedure in these patients. Methods: Between 1990 and 2013, 278 patients aged 18 years and above (mean 40.3 ± 10.6) underwent elective Ross procedure either by aortic root replacement (96%) or subcoronary technique (4%). Among them, 225 patients had predominant severe aortic stenosis; these patients form the study group. There were 171 patients with bicuspid valves and 34 redo operations, including previous aortic valve repair (n = 6) and AVR (n = 10) for severe aortic stenosis. Demographic, preoperative, postoperative, and longitudinal clinical and echocardiographic data were collected prospectively. Median and mean follow-up were 11.3 and 10.1 ± 5.9 (range 1-20.1) years. The follow-up was complete in all patients. Kaplan-Meier actuarial survival analysis was performed to assess long-term survival, freedom from reoperation for autograft and/or homograft failure, and freedom from autograft valve insufficiency. Results: Perioperative mortality was 0.9% (n = 2).The incidence of early reoperation for bleeding was 6.2%. Actuarial survival at 10 and 15 years following surgery was 91.6% and 90.2%. Ross-related reoperation occurred in 21 patients during follow-up: autograft dysfunction (n = 8), homograft dysfunction (n = 8), and in three patients, the ascending aorta was replaced. Freedom from Ross-related reoperation was 97.7% and 92.5% at 10 and 15 years, respectively. Freedom from reoperation for autograft failure was 98.9% and 96.4%. Freedom from reoperation for homograft failure was 97.6% and 96.7%. Freedom from moderate or severe autograft regurgitation was 98.3% and 91.9%, all at 10 and 15 years, respectively. Conclusions: Compared to recent literature of aortic bioprosthetic alternatives in young adults with severe aortic stenosis, the Ross procedure provides an excellent long-term option for these patients who seek a durable operation without anticoagulation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".