Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI study
Abstract Limited magnetic resonance imaging (MRI) data on autograft dilatation following the Ross procedure in congenital cohorts presents challenges in understanding its evolution and impact on clinical outcomes. This study, spanning from February 2003 to December 2022, included patients under 40 y...
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2025-01-01
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| author | Raphael Seiler Robin Stenzel Viktoria Weixler Milena Muiznieks Marina Gürtner Felix Berger Titus Kühne Mi-Young Cho Joachim Photiadis Marcus Kelm Peter Murin |
| author_facet | Raphael Seiler Robin Stenzel Viktoria Weixler Milena Muiznieks Marina Gürtner Felix Berger Titus Kühne Mi-Young Cho Joachim Photiadis Marcus Kelm Peter Murin |
| author_sort | Raphael Seiler |
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| description | Abstract Limited magnetic resonance imaging (MRI) data on autograft dilatation following the Ross procedure in congenital cohorts presents challenges in understanding its evolution and impact on clinical outcomes. This study, spanning from February 2003 to December 2022, included patients under 40 years at the time of the Ross procedure, with MRI follow-ups assessing dimensions at key aortic sites. Among 307 patients, 132 MRIs were analyzed from 76 individuals, revealing that autograft z-scores increase primarily with time post-procedure (Coef. 0.13; 95% CI:0.051–0.216; P = 0.002). Additionally, older patients at the time of surgery showed larger ascending aortic dimensions (Coef. 0.13; 95% CI:0.099–0.165; P = 0.001). Notably, autograft dilation at the sinus of Valsalva significantly predicted higher reintervention risks (HR 1.57; 95% CI:1.21–2.04; P = 0.001). Surgical reinforcement techniques of the autograft, via subcoronary implantation or external support, prevented such dilation (P < 0.001) and mitigated aortic regurgitation. In conclusion, our model predicted autograft dilation over time in patients after Ross procedure, aiding clinicians in making data-driven decisions regarding the optimal timing of the procedure and the selection of the most effective surgical strategy. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-51399660272c42e08e52ffe7a584d66a2025-01-26T12:23:45ZengNature PortfolioScientific Reports2045-23222025-01-0115111110.1038/s41598-025-86953-5Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI studyRaphael Seiler0Robin Stenzel1Viktoria Weixler2Milena Muiznieks3Marina Gürtner4Felix Berger5Titus Kühne6Mi-Young Cho7Joachim Photiadis8Marcus Kelm9Peter Murin10Deutsches Herzzentrum der Charité, Department of Congenital Heart Disease – Pediatric CardiologyCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDeutsches Herzzentrum der Charité, Department of Congenital and Pediatric Heart SurgeryCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinDeutsches Herzzentrum der Charité, Department of Congenital Heart Disease – Pediatric CardiologyDeutsches Herzzentrum der Charité, Institute of Computer-assisted Cardiovascular MedicineDeutsches Herzzentrum der Charité, Department of Congenital and Pediatric Heart SurgeryDeutsches Herzzentrum der Charité, Department of Congenital and Pediatric Heart SurgeryDeutsches Herzzentrum der Charité, Institute of Computer-assisted Cardiovascular MedicineDeutsches Herzzentrum der Charité, Department of Congenital and Pediatric Heart SurgeryAbstract Limited magnetic resonance imaging (MRI) data on autograft dilatation following the Ross procedure in congenital cohorts presents challenges in understanding its evolution and impact on clinical outcomes. This study, spanning from February 2003 to December 2022, included patients under 40 years at the time of the Ross procedure, with MRI follow-ups assessing dimensions at key aortic sites. Among 307 patients, 132 MRIs were analyzed from 76 individuals, revealing that autograft z-scores increase primarily with time post-procedure (Coef. 0.13; 95% CI:0.051–0.216; P = 0.002). Additionally, older patients at the time of surgery showed larger ascending aortic dimensions (Coef. 0.13; 95% CI:0.099–0.165; P = 0.001). Notably, autograft dilation at the sinus of Valsalva significantly predicted higher reintervention risks (HR 1.57; 95% CI:1.21–2.04; P = 0.001). Surgical reinforcement techniques of the autograft, via subcoronary implantation or external support, prevented such dilation (P < 0.001) and mitigated aortic regurgitation. In conclusion, our model predicted autograft dilation over time in patients after Ross procedure, aiding clinicians in making data-driven decisions regarding the optimal timing of the procedure and the selection of the most effective surgical strategy.https://doi.org/10.1038/s41598-025-86953-5Cardiac MRIRoss procedureCongenital heart diseaseAortic diseaseAutograft dilationAutograft reinforcement |
| spellingShingle | Raphael Seiler Robin Stenzel Viktoria Weixler Milena Muiznieks Marina Gürtner Felix Berger Titus Kühne Mi-Young Cho Joachim Photiadis Marcus Kelm Peter Murin Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI study Scientific Reports Cardiac MRI Ross procedure Congenital heart disease Aortic disease Autograft dilation Autograft reinforcement |
| title | Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI study |
| title_full | Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI study |
| title_fullStr | Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI study |
| title_full_unstemmed | Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI study |
| title_short | Autograft dilation after Ross procedure in children and young adults is mitigated by autograft reinforcement: A retrospective MRI study |
| title_sort | autograft dilation after ross procedure in children and young adults is mitigated by autograft reinforcement a retrospective mri study |
| topic | Cardiac MRI Ross procedure Congenital heart disease Aortic disease Autograft dilation Autograft reinforcement |
| url | https://doi.org/10.1038/s41598-025-86953-5 |
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