{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:03:52Z","timestamp":1790957032013,"version":"4.1.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,1,3]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The Ross operation appears to restore normal survival in young and middle\u2010aged adults with aortic valve disease. However, there are limited data comparing it with conventional aortic valve replacement. Herein, we compared outcomes of the Ross procedure with mechanical and bioprosthetic aortic valve replacement (M\u2010AVR and B\u2010AVR, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              MEDLINE and EMBASE were searched through March 2022 to identify randomized controlled trials and propensity score\u2013matched studies that investigated outcomes of patients aged \u226516\u2009years undergoing the Ross procedure, M\u2010AVR, or B\u2010AVR. The systematic literature search identified 2 randomized controlled trials and 8 propensity score\u2013matched studies involving a total of 4812 patients (Ross: n=1991; M\u2010AVR: n=2019; and B\u2010AVR: n=802). All\u2010cause mortality was significantly lower in the Ross procedure group compared with M\u2010AVR (hazard ratio [HR] [95% CI], 0.58 [0.35\u20130.97];\n              <jats:italic>P<\/jats:italic>\n              =0.035) and B\u2010AVR (HR [95% CI], 0.32 [0.18\u20130.59];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) groups. The reintervention rate was lower after the Ross procedure and M\u2010AVR compared with B\u2010AVR, whereas it was higher after the Ross procedure compared with M\u2010AVR. Major bleeding rate was lower after the Ross procedure compared with M\u2010AVR. Long\u2010term stroke rate was lower following the Ross procedure compared with M\u2010AVR and B\u2010AVR. The rate of endocarditis was also lower after the Ross procedure compared with B\u2010AVR.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Improved long\u2010term outcomes of the Ross procedure are demonstrated compared with conventional M\u2010AVR and B\u2010AVR options. These results highlight a need to enhance the recognition of the Ross procedure and revisit current guidelines on the optimal valve substitute for young and middle\u2010aged patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.027715","type":"journal-article","created":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T10:32:16Z","timestamp":1671877936000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":62,"title":["Ross Procedure Versus Mechanical Versus Bioprosthetic Aortic Valve Replacement: A Network Meta\u2010Analysis"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-9496","authenticated-orcid":false,"given":"Yujiro","family":"Yokoyama","sequence":"first","affiliation":[{"name":"Department of Surgery St. Luke\u2019s University Health Network Bethlehem 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University of Toronto, Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"El\u2010Hamamsy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Icahn School of Medicine at Mount Sinai New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7898-5159","authenticated-orcid":false,"given":"Shinichi","family":"Fukuhara","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery University of Michigan Ann Arbor 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