Aortic Root and Ascending Aortic Replacement Bentall or Ross Procedure? : Bentall or Ross Procedure?

概要

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The Ross procedure is occasionally favoured in young adults, with the implantation of a mechanical conduit remaining a competing option when simultaneous replacement of the ascending aorta is indicated. Eighteen patients with replacement of the ascending aorta, in addition to the Ross procedure (Ross), and 20 patients with a mechanical composite graft (composite) were compared retrospectively. The Short Form Health Survey (SF36) was used to assess quality of life (QoL). There was one death due to ischemic heart disease (composite), and one reoperation due to progressive autograft regurgitation (Ross). Autografts had pressure gradients of 3.1 ± 1.9 mmHg (versus 10.8 ± 2.7 mmHg composite; P < 0.001), and 7 autografts showed mild regurgitation. LV mass and global LV function were comparable in both groups (mean EF, 65.5% in Ross versus 61.6 ± 10.4% in composite, P = NS). Four allografts in a pulmonary position had mild regurgitation (Ross). Two allografts had mild to moderate, and one had moderate pressure gradients (mean, 14.4 mmHg). Patients in the composite group had higher SF36 scores indicating superior QoL. No major bleeding was noted throughout the follow-up period. Despite pre-OP diminished LV function, similar follow-up values and, surprisingly, a higher QoL outcome, favoured the implantation of mechanical conduits in our group. These results warrant further evaluation in larger patient cohorts.