The fate of the neoaortic valve and root after the modified Ross–Konno procedure Bahaa M. Fadel, MD, Cedric Manlhiot, BSc, Zohair Al-Halees, MD, Giovanni.

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Presentation transcript:

The fate of the neoaortic valve and root after the modified Ross–Konno procedure Bahaa M. Fadel, MD, Cedric Manlhiot, BSc, Zohair Al-Halees, MD, Giovanni Di Salvo, MD, Mamdouh Al-Ahmadi, MD, Brian McCrindle, MD, Bahaaldin Alsoufi, MD The Journal of Thoracic and Cardiovascular Surgery Volume 145, Issue 2, Pages 430-437.e1 (February 2013) DOI: 10.1016/j.jtcvs.2012.07.004 Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Trajectory of neoaortic annulus diameter growth over time is nonlinear and increases over time. The fine solid lines represent individual patient trajectories, and the heavy solid line is a smoothing spline that represents the best-fit average trend over time. Time zero was taken to be the date of the modified Ross–Konno procedure. B, Trajectory of neoaortic annulus z score over time. The fine solid lines represent individual patient trajectories, and the heavy solid line is a smoothing spline that represents the best-fit average trend over time. Time zero was taken to be the date of the modified Ross–Konno procedure. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 430-437.e1DOI: (10.1016/j.jtcvs.2012.07.004) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Trajectory of neoaortic annulus z score over time stratified by (A) age group: Older patients start with a lower neoaortic annulus z score immediately after the modified Ross–Konno procedure but have a trend for a more rapid increase in neoaortic annulus z score with time; and (B) requirement for additional surgery at the time of the modified Ross–Konno procedure: Patients who underwent additional cardiac surgery at the time of the modified Ross–Konno procedure had a faster increase in neoaortic annulus z score with time. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 430-437.e1DOI: (10.1016/j.jtcvs.2012.07.004) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Trajectory of neoaortic root diameter growth over time is nonlinear and increases over time. The fine solid lines represent individual patient trajectories, and the heavy solid line is a smoothing spline that represents the best-fit average trend over time. Time zero was taken to be the date of the modified Ross–Konno procedure. B, Trajectory of neoaortic root z score over time. The fine solid lines represent individual patient trajectories, and the heavy solid line is a smoothing spline that represents the best-fit average trend over time. Time zero was taken to be the date of the modified Ross–Konno procedure. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 430-437.e1DOI: (10.1016/j.jtcvs.2012.07.004) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Trajectory of neoaortic root z score over time stratified by age group: Older patients start with a lower neoaortic root z score immediately after the modified Ross–Konno procedure but have a trend for a more rapid increase in neoaortic root z score with time. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 430-437.e1DOI: (10.1016/j.jtcvs.2012.07.004) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 A, Trajectory of progression of AR jet width over LVOT diameter ratio (AR ratio): AR ratio was stable over time. The fine solid lines represent individual patient trajectories, and the heavy solid line is a smoothing spline that represents the best-fit average trend over time. Individual trajectories of patients with no regurgitation (AR ratio = 0) overlap with the horizontal axis. Time zero was taken to be the date of the modified Ross–Konno procedure. B, Trajectory of progression of AR jet width over LVOT diameter ratio (AR ratio) over time stratified by age groups: Older patients had a trend for a more rapid increase in AR ratio with time. AR, Aortic regurgitation. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 430-437.e1DOI: (10.1016/j.jtcvs.2012.07.004) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Time-related freedom from all-cause cardiac reoperation after the modified Ross–Konno procedure stratified by surgical era (A) and requirement of additional surgery at the time of the modified Ross–Konno procedure (B). The Journal of Thoracic and Cardiovascular Surgery 2013 145, 430-437.e1DOI: (10.1016/j.jtcvs.2012.07.004) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions