P306. Short-Term Outcomes of the Ross Procedure in Patients Greater and Less than 45 years of Age
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
University of Washington School of Medicine
Missoula, MT
United States - Contact Me
Anne Reimann-Moody is a second-year medical student at the University of Washington. She is from Missoula, Montana. After spending time at the University of Kentucky, Anne received her undergraduate degree in biology from the University of Montana. She plans to pursue cardiothoracic surgery as her career, with a focus on aortic or congenital surgery. Anne has a strong interest in research and advocacy. She appreciates the support and wisdom of her mentors, Dr. Scott DeRoo and Dr. Arjune Dhanekula. In her free time, Anne enjoyings trail running and rock climbing.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective: In the past decade, the Ross procedure has experienced a resurgence in popularity due to improved autograft longevity and potentially enhanced survival compared to current prosthetic valves. However, few studies have examined outcomes in patients older than 45 years old. In this study, perioperative outcomes after Ross procedure were compared between patients aged 45 (middle-aged) and patients < 45 (young).
Methods: From June 2020 to July 2023, 79 patients underwent a Ross procedure at one academic center. After excluding patients under age 18, 76 patients were stratified into cohorts of ages 18-44 (mean 32 ± 6.47 years, n=47) and ages 45 (mean 54.1± 5.23 years, n=29). Preoperative demographics, intraoperative characteristics, perioperative, and short-term outcomes were collected from the electronic health record. Normality of the variables was assessed using the Shapiro-Wilk test. Statistical comparisons were then performed using the t-test or the Mann-Whitney test for continuous variables, and Fisher's exact test for categorical variables.
Results: Mean age of the entire cohort was 40.4 ± 12.36 years, 72% of patients were male, and mean follow-up time was 10.8 months. 25% of patients (n=19) had prior cardiac surgery. Shortness of breath was the most common presenting symptom (47%, n=36), while 27% (n=21) were asymptomatic. 88% (n=67) had a preoperative EF of over 55%. The middle-aged cohort had higher rates of hypertension (48% vs 21%, p<0.05), hyperlipidemia (62% vs 6%, p=0.001), coronary artery disease (21% vs 2%, p=0.011) and a higher BMI (30.59 vs 25.72, p=0.002). Middle-aged patients had more isolated aortic stenosis, compared to a mixed pathology with an aortic stenosis predominance in the young cohort (69% vs 47%, p=0.002). Bypass time, cross-clamp time, and number of concomitant procedures performed were similar between cohorts. Post-operatively, the middle-aged cohort had a higher rate of atrial fibrillation (31% vs 11%, p <0.05), more frequently required prolonged inotropes (21% vs 2%, p<0.05), and had a longer median length of stay (8 days vs 7, p=0.02). There was one stroke in the middle-aged group, no in-hospital mortality in either group, and no significant difference in frequency of post-op pacemaker placement, reintervention, or readmission.
Conclusions: Peri-operative and short-term outcomes of the Ross procedure are similar when comparing cohorts of patients aged 18-44 and 45-60 years. It is reasonable to consider a Ross procedure in select middle-aged adults at an experienced Ross center.
Authors
Anne Reimann-Moody (1), Arjune Dhanekula (2), Michael Shang (2), Audrey Mossman (3), Rachel Flodin (2), David Mauchley (2), Chris Burke (2), Scott DeRoo (2)
Institutions
(1) University of Washington, Bozeman, MT, (2) University of Washington, Seattle, WA, (3) University of Washington, Laramie, WY
Methods: From June 2020 to July 2023, 79 patients underwent a Ross procedure at one academic center. After excluding patients under age 18, 76 patients were stratified into cohorts of ages 18-44 (mean 32 ± 6.47 years, n=47) and ages 45 (mean 54.1± 5.23 years, n=29). Preoperative demographics, intraoperative characteristics, perioperative, and short-term outcomes were collected from the electronic health record. Normality of the variables was assessed using the Shapiro-Wilk test. Statistical comparisons were then performed using the t-test or the Mann-Whitney test for continuous variables, and Fisher's exact test for categorical variables.
Results: Mean age of the entire cohort was 40.4 ± 12.36 years, 72% of patients were male, and mean follow-up time was 10.8 months. 25% of patients (n=19) had prior cardiac surgery. Shortness of breath was the most common presenting symptom (47%, n=36), while 27% (n=21) were asymptomatic. 88% (n=67) had a preoperative EF of over 55%. The middle-aged cohort had higher rates of hypertension (48% vs 21%, p<0.05), hyperlipidemia (62% vs 6%, p=0.001), coronary artery disease (21% vs 2%, p=0.011) and a higher BMI (30.59 vs 25.72, p=0.002). Middle-aged patients had more isolated aortic stenosis, compared to a mixed pathology with an aortic stenosis predominance in the young cohort (69% vs 47%, p=0.002). Bypass time, cross-clamp time, and number of concomitant procedures performed were similar between cohorts. Post-operatively, the middle-aged cohort had a higher rate of atrial fibrillation (31% vs 11%, p <0.05), more frequently required prolonged inotropes (21% vs 2%, p<0.05), and had a longer median length of stay (8 days vs 7, p=0.02). There was one stroke in the middle-aged group, no in-hospital mortality in either group, and no significant difference in frequency of post-op pacemaker placement, reintervention, or readmission.
Conclusions: Peri-operative and short-term outcomes of the Ross procedure are similar when comparing cohorts of patients aged 18-44 and 45-60 years. It is reasonable to consider a Ross procedure in select middle-aged adults at an experienced Ross center.
Authors
Anne Reimann-Moody (1), Arjune Dhanekula (2), Michael Shang (2), Audrey Mossman (3), Rachel Flodin (2), David Mauchley (2), Chris Burke (2), Scott DeRoo (2)
Institutions
(1) University of Washington, Bozeman, MT, (2) University of Washington, Seattle, WA, (3) University of Washington, Laramie, WY
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.