• Ismail Bouhout, Pierre-Emmanuel Noly, Aly Ghoneim, Louis-Mathieu Stevens, Raymond Cartier, Nancy Poirier, Denis Bouchard, Philippe Demers, and Ismail El-Hamamsy.
• Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Canada.
• Interact Cardiovasc Thorac Surg. 2017 Jan 1; 24 (1): 41-47.

ObjectivesThe aim of this study was to compare perioperative outcomes in young adults following isolated Ross procedure versus mechanical aortic valve replacement (AVR) in a high-volume centre.MethodsFrom 2007 to 2015, 337 elective isolated mechanical AVRs and 137 Ross procedures were performed in young adults (<65 years) at our centre. Using a 1:1 propensity score match analysis, 140 patients were included in the study (n = 70 in each group). Perioperative outcomes were defined using STS guidelines. The primary outcome was operative mortality.ResultsMedian age was 52 [14] years and EuroSCORE II was 1.0 [0.4]%. There were no mortalities in the two groups. There were no differences in the incidence of myocardial injury (0% overall) and neurological complications (0.7% overall). Three (4%) reinterventions for bleeding were required in the Ross cohort versus six (9%) in the mechanical AVR cohort (P = 0.49). A significant increase in serum creatinine (>2-fold increase) was more commonly observed after the Ross procedure (11 vs 1%; P = 0.03), but there was no significant difference in the rate of temporary dialysis. Twenty-seven patients (39%) required ≥1 blood product transfusion in the Ross group, whereas 21 patients (31%) did so in the mechanical AVR group (P = 0.47). Median hospital length of stay was similar in both the groups (6 days).ConclusionsThere are no differences in mortality or major perioperative outcomes in adults undergoing an isolated Ross procedure or mechanical AVR.© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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