Ross procedure and mechanical aortic valve replacement are two commonly used substitutes of the aortic valve in young and middle-aged adults. The objective of this study is to compare the long-term outcomes of the Ross procedure and mechanical aortic valve replacement in adults.
This systematic review and meta-analysis included 18 randomized clinical trials and observational studies extracted from the Ovid versions of MEDLINE and EMBASE classic. The eligible studies compared the Ross procedure with mechanical aortic valve replacement in adults (n=3,516) undergoing aortic valve replacement (AVR). The clinical outcomes of the Ross procedure and mechanical aortic valve replacement were examined. The primary outcome of the study was all-cause mortality.
During a median average follow-up of 5.8 years, 46% lower all-cause mortality was reported in patients undergoing Ross procedure, as compared with those who underwent mechanical aortic valve replacement. In addition, the Ross procedure was also associated with a lower risk of adverse events, including stroke IRR 0.26) and major bleeding (0.17). However, it was associated with a higher risk of intervention (IRR 1.76).
The research concluded that the Ross procedure was associated with a lower risk of all-cause mortality, as compared with mechanical aortic valve replacement.