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The Relationship Between Neo-Aortic Root Dilation, Insufficiency, and Reintervention Following the Ross Procedure in Infants, Children, and Young Adults

Sara K. Pasquali, MD^_*,||, Meryl S. Cohen, MD, FACC^_*,||, David Shera, ScD^,||, Gil Wernovsky, MD, FACC^_*,||, Thomas L. Spray, MD^,¶ and Bradley S. Marino, MD, MPP, MSCE, FACC^_*,,||,#,_*

^_* Division of Cardiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Division of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Division of Cardiothoracic Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Division of Critical Care Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
^|| Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
^¶ Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
^# Department of Anesthesiology and Critical Care at The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

View larger version (98K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Neo-Aortic Root Complex Two-dimensional echocardiographic image in parasternal long-axis view of the neo-aortic root. Diameter measurements of the neo-aortic annulus, root, and sinotubular junction are shown. AO = aorta; LA = left atrium; LV = left ventricle.

View larger version (27K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Mean Neo-Aortic Root z-Scores Over Time *Significant increase in raw measurements and z-scores for all neo-aortic root complex dimensions over time (*p < 0.001 for all). D/C = discharge; ST = sinotubular.

View larger version (15K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Kaplan-Meier Curves for Selected Events *Number of patients at risk for reintervention. AI = aortic insufficiency.

View larger version (10K): [in this window] [in a new window] [Download PPT slide]   Figure 4 Neo-Aortic Insufficiency D/C = discharge.