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Autograft Aortic Root Replacement Beats Homograft

Associated with higher survival rate at 10 years in aortic valve disease patients

TUESDAY, Aug. 3 (HealthDay News) -- Autograft aortic root replacement (Ross procedure) in patients with aortic valve disease results in significantly improved clinical outcomes compared to homograft aortic root replacement, according to a study published online Aug. 3 in The Lancet.

Ismail El-Hamamsy, M.D., of the Royal Brompton and Harefield NHS Trust in London, and colleagues randomized 228 patients to undergo the Ross procedure or homograft aortic root replacement. The researchers excluded 12 patients from the analysis because they were under 18 years of age.

The researchers found one perioperative death (less than 1 percent) among those who underwent the Ross procedure and three (3 percent) among those who underwent homograft aortic root replacement (P = 0.621). After 10 years, four patients who underwent the Ross procedure had died compared to 15 patients who underwent homograft aortic root replacement. Actuarial survival at 10 years was 97 percent in those who underwent the Ross procedure compared to 83 percent among those in the homograft group, with a hazard ratio for death in the homograft group of 4.61 (P = 0.0060).

"The Ross procedure, compared with homograft aortic root replacement, improved survival in adults, and was associated with improved freedom from reoperation and quality of life," the authors write. "The proportion of patients who survived after the Ross operation was similar to that in the general population."

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