Vol. 21 No. 1 (2017)
ACQUIRED HEART DISEASES

Lethality predictors in adults undergoing Ross procedure: analysis of 760 operations

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  • A. Karaskov,
  • A. Bogachev-Prokophiev,
  • E. Lenko,
  • I. Demin
A. Karaskov
Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, 630055 Novosibirsk, Russian Federation
A. Bogachev-Prokophiev
Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, 630055 Novosibirsk, Russian Federation
E. Lenko
Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, 630055 Novosibirsk, Russian Federation
Bio
I. Demin
Meshalkin Siberian Federal Biomedical Research Center, Ministry of Health of Russian Federation, 630055 Novosibirsk, Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2017-1-73-80

Published 2017-04-25

Keywords

  • Ross procedure,
  • in-patient lethality,
  • late lethality

How to Cite

Karaskov, A., Bogachev-Prokophiev, A., Lenko, E., & Demin, I. (2017). Lethality predictors in adults undergoing Ross procedure: analysis of 760 operations. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 21(1), 73–80. https://doi.org/10.21688/1681-3472-2017-1-73-80

Copyright (c) 2017 Karaskov A.M., Bogachev-Prokophiev A.V., Lenko E.V., Demin I.I.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Aim. This one-center cohort study focused on the identification of predictors of in-patient (up to 30 days) and late lethality in patients after Ross procedure over a period from 2002 to 2015.
Methods. 760 patients aged 16-73 were evaluated. The analysis included methods of descriptive statistics and Kaplan-Meyer survival test. To identify the factors related to lethality outcomes, use was made of a log rank test, a chi-square test and Cox regression analysis.
Results. In-patient lethality was from 0 to 5 deaths a year (95% confidence interval, 0 to 3), on average 5.6±1.6% (95% confidence interval; 4 to 7) over a period from 2002 to 2015. The cohort mean values of post-operative survival over 5 and 10 years were 98% and 98% respectively (late survival was 2%). The following statistically significant predictors of in-patient lethality (р<0.05) were revealed: type of surgical complications, type of suture used for transplant anastomosis, emergency coronary grafting, cardioplegia type, on-pump duration, New York Heart Association (NYHA) class, patient’s age. No statistically significant predictors of late lethality (р<0.05) were identified.
Conclusion. The existing protocols for coronary arteries deformation, leakage from each of six anastomoses, right ventricle autograft bed, obligatory use of artificial circulation should be updated and added to the relevant Ross procedure guidelines.

Received 22 December 2016. Accepted 14 March 2017.

Financing: The study did not have sponsorship.

Conflict of interest: Authors declare no conflict of interest.

Acknowledgments: The authors are grateful to Dr. Ponomarev D.N., Cand. Sci., for advice on biostatistics when preparing the article for submission.

PDF (Русский)

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