{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T03:51:47Z","timestamp":1788580307646,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Aortic stenosis or regurgitation in patients with a unicuspid valve morphology requires interventions early in life. We have performed either primary valve repair or the Ross procedure. The goal of this study was to compare the midterm results of repair and pulmonary autograft replacement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between December 1998 and April 2022, a total of 345 patients (77% male; mean age 34\u2009\u00b1\u20099.7\u2009years) underwent treatment of a unicuspid aortic valve. Patients were excluded if they were &amp;lt;18\u2009years (n\u2009=\u200984) or &amp;gt;54\u2009years (n\u2009=\u20093) at the time of the operation. The remaining cohort was divided into 2 groups: 167 (64%) patients underwent valve repair; 91 (36%) patients underwent pulmonary autograft replacement.<\/jats:p>\n                  <jats:p>The indications for surgery were aortic regurgitation (n\u2009=\u2009104), aortic stenosis (n\u2009=\u200945), combined disease (n\u2009=\u2009103) and endocarditis (n\u2009=\u20096). Fifty-one patients had root dilatation (&amp;gt;43 mm) with aortic regurgitation (repair n\u2009=\u200923; Ross n\u2009=\u200928). Mean follow-up was 5.9 years (SD: 5\u2009years) [range 0.1\u201322.3\u2009years].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>There were 1 early and 3 late deaths; 47 patients required reintervention. Survival at 10\u2009years was 95% in the Ross group and 97% after valve repair (P\u2009=\u20090.769). Freedom from reintervention at 10\u2009years was 98% in the Ross group and 80% after valve repair (P\u2009=\u20090.012). A receiver operating characteristics curve analysis showed a trend towards better durability in patients &amp;lt; 26\u2009years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The ideal treatment of the unicuspid aortic valve remains debatable. Repair of a unicuspid valve can be considered a bridge to pulmonary autograft replacement, at least in younger patients. The appropriate times to replace and to repair require further investigation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad118","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T14:07:19Z","timestamp":1679666839000},"source":"Crossref","is-referenced-by-count":13,"title":["The Ross procedure versus repair for treatment of a unicuspid aortic valve in adults"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-3124","authenticated-orcid":false,"given":"Karen B","family":"Abeln","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9415-5788","authenticated-orcid":false,"given":"Shunsuke","family":"Matsushima","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kobe Children\u2019s Hospital , Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6217-5963","authenticated-orcid":false,"given":"Tristan","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5367-6819","authenticated-orcid":false,"given":"Christian","family":"Giebels","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0251-9100","authenticated-orcid":false,"given":"Hans-Joachim","family":"Sch\u00e4fers","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"2023080808295324100_ezad118-B1","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1161\/01.CIR.0000155623.48408.C5","article-title":"Frequency by decades of unicuspid, bicuspid, and tricuspid aortic valves in adults having isolated aortic valve replacement for aortic stenosis, with or without associated aortic regurgitation","volume":"111","author":"Roberts","year":"2005","journal-title":"Circulation"},{"key":"2023080808295324100_ezad118-B2","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.cjca.2015.10.028","article-title":"New Insights Into Unicuspid Aortic Valve Disease in Adults: not Just a Subtype of Bicuspid Aortic Valves","volume":"32","author":"Noly","year":"2016","journal-title":"Can J 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