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  • 1
    Online Resource
    Online Resource
    Autograft Regurgitation and Aortic Root Dimensions After the Ross Procedure : The German Ross Registry Experience
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. 11_supplement ( 2007-09-11)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. 11_supplement ( 2007-09-11)
    Abstract: Background— Autograft regurgitation and root dilatation after the Ross procedure is of major concern. We reviewed data from the German Ross Registry to document the development of autograft regurgitation and root dilatation with time and also to compare 2 different techniques of autograft implantation. Methods and Results— Between 1990 and 2006 1014 patients (786 men, 228 women; mean age 41.2±15.3 years) underwent the Ross procedure using 2 different implantation techniques (subcoronary, n =521; root replacement, n =493). Clinical and serial echocardiographic follow up was performed preoperatively and thereafter annually (mean follow up 4.41±3.11 years, median 3.93 years, range 0 to 16.04 years; 5012 patient-years). For statistical analysis of serial echocardiograms, a hierarchical multilevel modeling technique was applied. Eight early and 28 late deaths were observed. Pulmonary autograft reoperations were required in 35 patients. Initial autograft regurgitation grade was 0.49 (root replacement 0.73, subcoronary 0.38) with an annual increase of grade 0.034 (root replacement 0.0259, subcoronary 0.0231). Annulus and sinus dimensions did not exhibit an essential increase over time in both techniques, whereas sinotubular junction diameter increased essentially by 0.5 mm per year in patients with root replacement. Patients with the subcoronary implantation technique showed nearly unchanged dimensions. Bicuspid aortic valve morphology did not have any consistent impact on root dimensions with time irrespective of the performed surgical technique. Conclusions— The present Ross series from the German Ross Registry showed favorable clinical and hemodynamic results. Development of autograft regurgitation for both techniques was small and the annual progression thereof is currently not substantial. Use of the subcoronary technique and aortic root interventions with stabilizing measures in root replacement patients seem to prevent autograft regurgitation and dilatation of the aortic root within the timeframe studied.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.106.678797
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 2
    Online Resource
    Online Resource
    Energy conversion in the Cape Verde Frontal Zone
    American Geophysical Union (AGU) ; 1998
    In:  Journal of Geophysical Research: Oceans Vol. 103, No. C10 ( 1998-09-15), p. 21469-21479
    Details
    In: Journal of Geophysical Research: Oceans, American Geophysical Union (AGU), Vol. 103, No. C10 ( 1998-09-15), p. 21469-21479
    Abstract: Mechanical energy terms are calculated from moored current meter data in the Cape Verde Frontal Zone (about 20°N, 25°W) and compared with those derived from a mesoscale model of this frontal region. The model is of the Bleck and Boudra [1981] type with isopycnal coordinates. An initially zonal jet, representing the Canary Current, is allowed to develop under the influence of baroclinic and barotropic instability processes. We find reasonable agreement in magnitudes, somewhat smaller in the model, and similar distributions in the vertical. This leads to the conclusion that the energy transfer terms from the model can be expected to be sufficiently close to reality. Determination of the transfer terms confirms that the energy transfer in the zone is dominated by baroclinic instability processes while barotropic instability is of minor importance. Average baroclinic instability energy transfer terms reach values of 2–3 μW m −3 in the pycnocline. Peak layer mean values are of the order 10 μW m −3 . It is shown that the spatial distribution of active transfer regions is closely related to the structure of the transient eddy field in the frontal zone and that strong instability processes are restricted to the pycnocline.
    Type of Medium: Online Resource
    ISSN: 0148-0227
    URL: Article
    DOI: 10.1029/98JC01887
    Language: English
    Publisher: American Geophysical Union (AGU)
    Publication Date: 1998
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    detail.hit.zdb_id: 3094268-8
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    detail.hit.zdb_id: 2016804-4
    detail.hit.zdb_id: 3094181-7
    detail.hit.zdb_id: 3094219-6
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    detail.hit.zdb_id: 2220777-6
    detail.hit.zdb_id: 3094197-0
    SSG: 16,13
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  • 3
    Online Resource
    Online Resource
    Ross Procedure and Left Ventricular Mass Regression
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  Circulation Vol. 112, No. 9_supplement ( 2005-08-30)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 112, No. 9_supplement ( 2005-08-30)
    Abstract: Background— Return of left ventricular mass to normal is considered to be a favorable result of aortic valve replacement. The Ross procedure provides near normal hemodynamics and thus allows studies of left ventricular (LV) reverse remodeling. LV mass regression may be influenced by surgical technique (subcoronary [SC] versus root replacement [RR] ). Methods and Results— Data from the German Ross Registry were analyzed. A total of 646 patients (mean age: 43.6±12.7 years, range: 16 to 71 years; SC technique n=295, RR technique n=351) underwent a Ross procedure in 7 participating centers from 1990 to 2004. The patients underwent preoperative and postoperative echocardiographic evaluations. Mean follow-up time was 3.5±2.5 years (range 0.12 to 13.7 years). Follow-up completeness was 97%. The LV mass index (LVMI) decreased significantly during follow-up in both groups (SC: 209±53 preoperatively to 154±48 at 1-year follow-up, [ P 〈 0.01 versus preoperative values] to 149±51g/m 2 at 2-year follow-up, [ P =NS 1-year versus 2-year follow-up] versus RR: from 195±56 preoperatively to 144±51 at 1-year follow-up [ P 〈 0.01 versus preoperative values] to 140±49g/m 2 [ P =NS 1-year versus 2-year follow-up]). LVMI regression remained stagnant 1 year after the Ross procedure in most patients in both groups. On the basis of multivariate analysis, predictors for incomplete LVMI regression after the autograft procedure were high preoperative LVMI, smoking, and uncontrolled diastolic hypertension. Conclusions— At mid-term echocardiographic follow-up, patients of both groups had favorable autograft hemodynamics. Risk factors for incomplete postoperative LVMI regression in our study were smoking and persistent diastolic hypertension. This emphasizes the importance of cessation of smoking and treatment of arterial hypertension, even in younger patients, after corrected aortic valve disease.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.104.525444
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2005
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
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