Subcoronary versus full-root Ross procedure for the paediatric population: an early-to-midterm bicentric experience
Bibliographic record
Abstract
OBJECTIVES: With 2 different Ross autograft implantation techniques: subcoronary versus full-root evolving, the question remains which strategy demonstrates the better early/mid-term performance, especially concerning autograft durability. METHODS: Patients (0-18 years) undergoing Ross procedure from January 2012 to December 2022 in 2 high-volume centres were included. Patients undergoing both subcoronary and full-root Ross were analysed for early mortality, direct postoperative complications, 5-year survival, incidence of reinterventions/reoperations and autograft durability over time. Propensity score matching and regression analysis were used to overcome institutional differences. RESULTS: A total of 205 paediatric patients were included [median age at Ross: 7.6 years (1.9-13.5), 67% males]. No differences in baseline characteristics were noted between the groups, except for prior aortic valve repair, which occurred more frequently in the full-root Ross (19% vs 6.9%; P = 0.03). Cardiopulmonary bypass durations (median 265 vs 221 min, P < 0.01), ventilatory support and hospital stay were significantly longer in the subcoronary Ross (P = 0.02) with no differences in any postoperative complications. No differences were noted in 5-year survival [full-root: 93.3% (87.5-96.5) versus subcoronary: 96.5% (86.6-99.1), P = 0.45], incidence of autograft reoperations [full-root: 3.2% (1-9.9) versus subcoronary: 2.1% (0.3-14.9), P = 0.98] or incidence of autograft regurgitation ≥ moderate [full-root: 9.8% (5.3-18.2) versus subcoronary: 9.7% (3.1-30.5), P = 0.85) between the groups, also after matching. CONCLUSIONS: Independent of the technique, Ross procedure is performed with excellent survival and low autograft reoperation rates in high-volume centres. The longer, technically more challenging subcoronary Ross demonstrated no differences in early postoperative complications. A superiority in autograft durability has so far not been noticed either in the medium-term follow-up.
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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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".