P760The Ross procedure versus mechanical aortic valve replacement in adults: a systematic review and meta-analysis
Bibliographic record
Abstract
Background: Young and middle-aged adults with diseased aortic valves constitute a challenging population. Owing to a longer life expectancy, these patients present a higher cumulative lifetime risk of prosthesis-related complications. The ideal aortic valve substitute in young and middle-aged adults remains unknown. Purpose: We aimed to compare long-term outcomes in adult patients who undergo the Ross procedure versus mechanical aortic valve replacement (AVR). Methods: We conducted a systematic review and meta-analysis in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. We systematically searched OVID versions of MEDLINE (1946 to December, 2016) and EMBASE Classic (1947 to December, 2016) for relevant studies using the following text word search in the title or abstract: (“Ross” OR “autograft”) AND (“aortic” OR “mechanical”). We included all randomised controlled trials (RCT) and observational studies comparing the Ross procedure to the use of mechanical prostheses in adults undergoing AVR. The primary outcome was all-cause mortality and was assessed using a random effects model. Results: Our search identified 1893 reports, of which 17 studies (2966 patients) met our inclusion criteria, including one RCT and 16 observational studies, with a median follow-up of 5.7 years (interquartile range 3.1–7.9 years). Analysis of the primary outcome demonstrated a 42% lower all-cause mortality in patients undergoing the Ross procedure compared with mechanical AVR (incidence rate ratio [IRR] 0.58, 95% confidence interval [CI] 0.36–0.92; I2=27%). The Ross procedure was also associated with lower rates of stroke (IRR 0.26, 95% CI 0.09–0.80; I2=8%) and major bleeding (IRR 0.17, 95% CI 0.07–0.40; I2=0%), but higher rates of reintervention (IRR 1.76, 95% CI 1.16–2.65; I2=0%). Figure 1. All-cause mortality forest plot Conclusion: Data from primarily observational studies suggest that the Ross procedure is associated with a lower risk of all-cause mortality compared with mechanical AVR. These findings highlight the need for a large, prospective RCT comparing long-term outcomes between these two interventions.
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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.022 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.015 | 0.031 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".