Fate of the Remaining Neo-Aortic Root After Autograft Valve Replacement With a Stented Prosthesis for the Failing Ross Procedure Bahaaldin Alsoufi, MD,

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Presentation transcript:

Fate of the Remaining Neo-Aortic Root After Autograft Valve Replacement With a Stented Prosthesis for the Failing Ross Procedure Bahaaldin Alsoufi, MD, Dalia Ahmed, MD, Cedric Manlhiot, BS, Zohair Al-Halees, MD, Brian W. McCrindle, MD, Bahaa M. Fadel, MD The Annals of Thoracic Surgery Volume 96, Issue 1, Pages 59-65 (July 2013) DOI: 10.1016/j.athoracsur.2013.04.034 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Trajectory of aortic root diameter increase after autograft valve replacement (AuVR) over time is linear, and increases over time. Circles represent individual data points (there are >1 data point per patient). Fine solid lines represent individual patient trajectories and heavy solid line is a smoothing spline that represents best-fit average trend over time. Time zero was taken to be date of AuVR. The Annals of Thoracic Surgery 2013 96, 59-65DOI: (10.1016/j.athoracsur.2013.04.034) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Trajectory of aortic root diameter increase after autograft valve replacement (AuVR), stratified by the mode of autograft failure. Patients with autograft failure due to annular dilatation (dotted line) started with a larger root than those with recurrent inflammation (solid line) and showed faster increase in diameter with time. The Annals of Thoracic Surgery 2013 96, 59-65DOI: (10.1016/j.athoracsur.2013.04.034) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Trajectory of aortic root diameter increase after autograft valve replacement (AuVR) stratified by base root diameter prior to AuVR; there was no significant difference in the rate of root diameter increase based on indexed initial root size at time of AuVR equal or more than 2.2 (dotted line) or less than 2.2 (solid line). (BSA = body surface area.) The Annals of Thoracic Surgery 2013 96, 59-65DOI: (10.1016/j.athoracsur.2013.04.034) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Trajectory of ascending aortic (Asc Ao) diameter increase after autograft valve replacement (AuVR) over time is linear, and increases over time. Circles represent individual data points (there are >1 data point per patient). Fine solid lines represent individual patient trajectories and heavy solid line is a smoothing spline that represents best-fit average trend over time. Time zero was taken to be date of AuVR. The Annals of Thoracic Surgery 2013 96, 59-65DOI: (10.1016/j.athoracsur.2013.04.034) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Trajectory of ascending aorta (Asc Ao) diameter increase after autograft valve replacement (AuVR), stratified by the mode of autograft failure. Patients with autograft failure due to annular dilatation (dotted line) started with larger ascending aorta than those with recurrent inflammation (solid line) but diameter increase rate was not significantly faster. The Annals of Thoracic Surgery 2013 96, 59-65DOI: (10.1016/j.athoracsur.2013.04.034) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Trajectory of ascending aorta (Asc Ao) diameter increase after autograft valve replacement (AuVR) stratified by base ascending aorta diameter prior to AuVR. There was no significant difference in the rate of ascending aorta diameter increase based on indexed initial ascending aorta size at time of AuVR equal or more than 2.0 (dotted line) or less than 2.0 (solid line). (BSA = body surface area.) The Annals of Thoracic Surgery 2013 96, 59-65DOI: (10.1016/j.athoracsur.2013.04.034) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions