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Outcomes Compared for Aortic Valve Replacement Options in Adults

Ross procedure associated with better long-term survival than biological and mechanical AVR in adults aged 18 to 50 years

THURSDAY, March 10, 2022 (HealthDay News) — In younger adults, the Ross procedure is associated with better long-term survival than prosthetic aortic valve replacement (AVR), according to a study published in the March 1 issue of the Journal of the American College of Cardiology.

Ismail El-Hamamsy, M.D., Ph.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues compared long-term outcomes after the Ross procedure versus biological and mechanical aortic valve replacement (AVR) in adults (aged 18 to 50 years) undergoing aortic valve surgery (1997 to 2014). The analysis included 434 patients per group with a median follow-up of 12.5 years.

The researchers found that at 15 years, actuarial survival was 93.2 percent after the Ross procedure, 87.9 percent after biological AVR, and 88.4 percent after mechanical AVR. After the Ross procedure, survival was similar to that of the age-, sex-, and race-matched U.S. general population. The Ross procedure was associated with a significantly lower risk for mortality compared with biological AVR and mechanical AVR (hazard ratios, 0.42 and 0.45, respectively). With regard to reoperation, the risk after the Ross procedure was lower than the risk after biological AVR and higher than the risk after mechanical AVR. With regard to the long-term risk for stroke, the risk after the Ross procedure was similar to the risk after biological AVR and lower than the risk after mechanical AVR.

“This confirms the notion that a living valve substitute in the aortic position translates into improved clinically relevant outcomes,” the authors write.

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