Table 1. Summary of studies comparing outcomes of the Ross procedure in adults with AS versus AR.
| Study | # of patients | Mean age (years) | BAV/UAV/QAV (%) | AS (%)/AR (%)/mixed AS-AR (%) | Surgical technique | Annuloplasty (%) | Annuloplasty type | Mean follow-up (years) | Freedom from autograft reoperation |
|---|---|---|---|---|---|---|---|---|---|
| David et al. [2010] (20) | 212 | 34±9 | 82 | 50/36/13 | RR (51%), SC/inclusion (49%) | 46 | Subcommissural plication + partial Dacron strip | 10.1±4.2 | At 15 years: AS 97%, AR 84% |
| Weimar et al. [2014] (25) | 645 | 42±14 | 58 | 32/29/33 | RR (98%), SC (2%) | 63 | Dacron strip | 8.4±4.6 | At 10 years: AS 97%, AI 90% |
| Skillington et al. [2015] (23) | 322 | 40 (range 15–63) | 95 | 46/32/22 | Inclusion (100%) | 62 | Circumferential ring (5%), partial ring (30%), partial ring + annular plication (25%), annular plication (2%) | 9.8 | At 18 years: 96% overall AS: n=1, AR: n=9, AS/AR: n=1 |
| Mastrobuoni et al. [2016] (26) | 306 | 42±10 | 59 | 68/31/0 | SC (2%), RR (55%), inclusion (43%) | N/A | N/A | 10.6 | At 16 years: AS 83%, AR 65% |
| Charitos et al. [2012] (21) | 1760 | 44±12 | 71 | 24/23/51 | SC (44%), RR (56%) | 35 | N/A | 7.1±4.6 | HR (AR vs. AS): 2.3 (95% CI: 1.5–3.5), P<0.001 |
| Da Costa et al. [2014] (27) | 414 | 31±13 | 50 | 29/39/31 | RR (86%), inclusion (14%) | 7 | External strip of Dacron/pericardium | 8.2±5.2 | At 15 years: 91% overall |
| Martin et al. [2017] (22) | 310 | 41±11 | 78 | 73/19/7 | RR (84%), inclusion (11%), SC (6%) | 1 | N/A | 15.1 (IQR 5.5–18.4) | HR (AR vs. AS): 2.7 (95% CI: 1.4–5.1), P=0.002 |
| Ryan et al. [2011] (28) | 160 | 42±11 | 87 | 42/58/0 | RR | 38 | Circumferential suture annuloplasty | AS 4.5±2.9, AR 6.0±3.2 | At 10 years: AS 95%±5%, AR 67%±9% |
AR, aortic regurgitation; AS, aortic stenosis; BAV, bicuspid aortic valve; HR, hazard ratio; IQR, interquartile range; QAV, quadricuspid aortic valve; RR, root replacement; SC, subcoronary; UAV, unicuspid aortic valve.