{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:55:34Z","timestamp":1789556134545,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Montreal Heart Institute Department of Cardiac Surgery"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>The Ross procedure in patients with aortic regurgitation (AR) has been associated with increased autograft dilatation and late reintervention. The aim of this study was to evaluate the impact of a tailored approach aimed at mitigating that risk on early changes in autograft root dimensions following the Ross procedure in patients with AR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>From 2011 to 2018, 241 consecutive patients underwent a Ross procedure with &gt;1\u2009year of follow-up [46 (7)\u2009years]. Aortic root dimensions were prospectively measured on serial echocardiograms. Patients with aortic stenosis group (n\u2009=\u2009171; 71%) were compared to those with AR or mixed aortic disease (AR group) (n\u2009=\u200970; 29%). Mean length of follow-up was 29\u2009\u00b1\u200911\u2009months (100% complete). Changes in aortic dimensions were analysed using mixed-effect models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>At 4\u2009years, mean indexed diameters of the annulus, sinuses of Valsalva and the sinotubular junction in the AR group were 12.3 (0.2) mm\/m2, 20.0 (0.4) mm\/m2 and 16.3 (0.9) mm\/m2, respectively, vs 11.9 (0.2), 18.4 (0.3) and 15.5 (0.5) in the aortic stenosis group. Overall, there were no significant differences in the rates of autograft annulus, sinuses of Valsalva and sinotubular junction dimension changes between the aortic stenosis and AR groups up to 4\u2009years after surgery (P\u2009=\u20090.55, P\u2009=\u20090.12, P\u2009=\u20090.59 and P\u2009=\u20090.48, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Use of a tailored surgical approach, combined with a strict blood pressure control, appears to mitigate clinically significant early dilatation of the autograft root following a Ross procedure in patients with AR. Further follow-up is needed to determine if this will translate into a lower incidence of long-term reintervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezz105","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T15:13:54Z","timestamp":1552058034000},"page":"959-967","source":"Crossref","is-referenced-by-count":44,"title":["Impact of a tailored surgical approach on autograft root dimensions in patients undergoing the Ross procedure for aortic regurgitation\u2020"],"prefix":"10.1093","volume":"56","author":[{"given":"Ismail","family":"Bouhout","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly","family":"Ghoneim","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tousch","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis Mathieu","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Semplonius","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Tarabzoni","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Poirier","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Cartier","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Demers","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linrui","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W A","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"El-Hamamsy","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,1]]},"reference":[{"key":"2019101705190435400_ezz105-B1","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1016\/j.athoracsur.2014.02.019","article-title":"The perimount valve in the aortic position: twenty-year experience with patients under 60 years old","volume":"97","author":"Forcillo","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2019101705190435400_ezz105-B2","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/j.jtcvs.2013.10.064","article-title":"Long-term outcomes after elective isolated mechanical aortic valve replacement in young adults","volume":"148","author":"Bouhout","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2019101705190435400_ezz105-B3","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.cjca.2014.02.018","article-title":"Canadian Cardiovascular Society position statement on the management of thoracic aortic disease","volume":"30","author":"Boodhwani","year":"2014","journal-title":"Can J Cardiol"},{"key":"2019101705190435400_ezz105-B4","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/icvts\/ivw325","article-title":"Is the Ross procedure a riskier operation? 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