Abstract 14923: Is the Ross Procedure a Riskier Operation? - Perioperative Outcome Comparison With Mechanical Aortic Valve Replacement in a Propensity-Matched Cohort
Bibliographic record
Abstract
Introduction: Despite reports of improved long-term survival after the Ross procedure, concerns remain regarding increased surgical complexity and potential morbidity compared to standard aortic valve replacement (AVR). Hypothesis: The aim of this study was to compare perioperative outcomes in young adults following a Ross procedure versus mechanical AVR in the current era. Patients and methods: From 2007 to 2015, 337 elective isolated mechanical AVRs and 137 Ross procedures were performed in young adults (<65 years) at our center. The Ross cohort includes the learning curve. Patients with concomitant ascending aorta replacement were included (78 (57%) in the Ross group and 58 (17%) in the AVR group). Using a 1:1 propensity score match analysis, 164 patients were included in the study (n=82 in each group). Mean age was 48±11 years and Euroscore II was 1.1±0.6%. Perioperative outcomes were defined using STS guidelines. Results: There were no mortalities in the two groups. Mean cardiopulmonary bypass and crossclamp times were longer in the Ross cohort (210+/-28 and 185+/-24 min vs 82+/-29 and 62+/-21 min respectively; p< 0.001). There were no differences in the incidence of myocardial injury (0% overall), neurological complications (0.6% overall) or intubation times (p=NS). Three (3.7%) reinterventions for bleeding were reported in the Ross cohort and 4 (4.9%) in the mechanical AVR cohort (p>0.99). A significant increase in serum creatinine (>2-fold increase) was more commonly observed after the Ross procedure (11% versus 0%; p=0. 003), but there was no significant difference in the rate of temporary dialysis (p=0.25). Six of 9 patients (67%) with increased creatine levels occurred in the first tertile of the Ross cohort. Thirty patients (37%) required ≥1 blood product transfusion in the Ross group compared to 26 patients (32%) in the mechanical AVR group (p=0.5). Median hospital length of stay was similar in both groups (6 days in each; p=0.99). Conclusion: There are no differences in mortality or major perioperative outcomes in adults undergoing a Ross procedure or mechanical AVR. Acute renal injury in the Ross cohort was closely linked to the learning curve. Further follow-up is required to evaluate long-term outcomes in these cohorts.
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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".