Congenital DisordersNCT00267995
Ross Aortic Valve Replacement Patients
An observational study of Congenital Disorders, run by Children's Healthcare of Atlanta at 1 site in United States.
Trial summary
The Ross procedure has become the surgery of choice for aortic valve replacement in children. This consists of taking a child's own pulmonary valve (the autograft) and replacing the child's diseased aortic valve with the autograft. Read more about this study
- Who is it for?
- Ages Up to 21 years
- Conditions the study is for
- Congenital Disorders
- How many people
- 75 participants
- Where
- 1 siteUnited States
- Study dates
- Dec 1994to not given
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 21 years
- All sexes
- No healthy volunteers
- Child, Adult
Study population: Retro chart review
Who may be able to join
- Ross procedure with and without Proximal butressing technique
- Ross procedure between 12.1994 and 8.2003
Who cannot join
- those who do not meet inclusion criteria
Trial locations and contacts
1 site in 1 country.
United States1 site
Children's Healthcare of Atlanta
Atlanta, Georgia, 30322
About this study
Official title: Proposal for Retrospective Review of Ross Aortic Valve Replacement Patients
The Ross procedure has become the surgery of choice for aortic valve replacement in children. This consists of taking a child's own pulmonary valve (the autograft) and replacing the child's diseased aortic valve with the autograft. At times, this can involve either enlarging or reducing the diameter of the aortic annulus to make the valve fit properly. The patient's own pulmonary valve is then replaced, most typically with a human heart valve (a homograft). There has been some concern in the literature that as time goes on, the autograft will dilate and the patient will develop progressive aortic insufficiency.
Since 1994, we have performed almost 50 Ross procedures in children and young adults. Contrary to many reports from the literature, we have not recognized a problem with autograft enlargement and progressive aortic insufficiency. One thing that we have done differently from other centers is that we have modified the insertion technique of the autograft into the native aortic root. This involves a second buttressing suture layer. Not only does this have the immediate effect of reducing bleeding complications, we postulate that it has the long-term effect of stabilizing the autograft and preventing aortic root dilatation.
We hypothesize that this proximal buttressing technique for the Ross procedure has a two-fold benefit. Firstly, it reduces the amount of bleeding in the postoperative period. Secondly, it prevents late autograft root dilatation.
Read the detailed description
This is a retrospective chart review examining our experience with the Ross procedure. There will be a treatment and control group. The treatment group will be children who have had the Ross procedure with the proximal buttressing technique. The control or comparisons group would be Ross procedure patients who did not receive the proximal buttressing technique. All children's charts reviewed will be of patients who had their surgery at Children's Healthcare of Atlanta between December 1994 and August 2003; only information available up until October 10, 2003 will be used for this study. We will review approximately 75 charts for this study.
The first aim of the study would be to examine basic information regarding bleeding incidence. The following information will be collected on both groups:
- Amount of chest tube bleeding within the first 24 hours, and
- Number of patients who required re-exploration for bleeding
- Time from cardiopulmonary bypass removal to time leaving the operating room (indicator of the need to "dry up").
The second aim of the study would be to review the echocardiograms on these patients. The pulmonary valve size before the Ross procedure would be measured on the preoperative transthoracic or transesophageal echocardiogram. This would then be compared with postoperative studies in the Operating Room by transesophageal echocardiography. The pre-discharge echocardiogram and follow-up echocardiograms (which are a routine for these patients and, therefore, would not be necessary to add to the study protocol) would be reviewed. Autograft root diameters would be measured. The diameters would be at the level of the valve leaflets, at the level of the commissures and at the sinotubular ridge. These would be compared against published Z values for these patients by age, weight and body surface area. At the same time, any degree of aortic insufficiency or left ventricular outflow tract obstruction would be noted and recorded. One non-invasive cardiologist will review all old echocardiograms.
- Conditions
- Congenital Disorders
- Keywords
- Pediatric, cardiac, Ross procedure, Aortic valve replacement, Proximal buttressing technique
- Medical subject headings
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Dec 2005 (estimated)
- Study startDec 1994
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Congenital DisordersStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Time perspective
- Retrospective
- Enrolment
- 75 participants (actual)
Sponsor and investigators
- Lead sponsor
- Children's Healthcare of Atlanta
- Sponsor type
- University, hospital or other
- Investigators
- Kirk R. Kanter, MD, Principal investigator, Children's Healthcare of Atlanta
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00267995
- Sponsor's protocol ID
- 03-047
- Status last verified
- May 2007
- First submitted
- 20 Dec 2005
- Last updated
- 6 Jul 2011
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 Jul 2011. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Proposal for Retrospective Review of Ross Aortic Valve Replacement Patients
- ClinicalTrials.gov ID
- NCT00267995
- Acronym / sponsor ID
- 03-047
- Conditions
- Congenital Disorders
- Keywords
- Pediatric, cardiac, Ross procedure, Aortic valve replacement, Proximal buttressing technique
- Study type
- Observational
- Recruitment status
- Terminated
- Enrolment
- 75 participants (actual)
- Lead sponsor
- Children's Healthcare of AtlantaUniversity, hospital or other
- Study start
- Dec 1994
- First posted
- 22 Dec 2005 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The Ross procedure has become the surgery of choice for aortic valve replacement in children. This consists of taking a child's own pulmonary valve (the autograft) and replacing the child's diseased aortic valve with the autograft. At times, this can involve either enlarging or reducing the diameter of the aortic annulus to make the valve fit properly. The patient's own pulmonary valve is then replaced, most typically with a human heart valve (a homograft). There has been some concern in the literature that as time goes on, the autograft will dilate and the patient will develop progressive aortic insufficiency.
Since 1994, we have performed almost 50 Ross procedures in children and young adults. Contrary to many reports from the literature, we have not recognized a problem with autograft enlargement and progressive aortic insufficiency. One thing that we have done differently from other centers is that we have modified the insertion technique of the autograft into the native aortic root. This involves a second buttressing suture layer. Not only does this have the immediate effect of reducing bleeding complications, we postulate that it has the long-term effect of stabilizing the autograft and preventing aortic root dilatation.
We hypothesize that this proximal buttressing technique for the Ross procedure has a two-fold benefit. Firstly, it reduces the amount of bleeding in the postoperative period. Secondly, it prevents late autograft root dilatation.
Detailed description
This is a retrospective chart review examining our experience with the Ross procedure. There will be a treatment and control group. The treatment group will be children who have had the Ross procedure with the proximal buttressing technique. The control or comparisons group would be Ross procedure patients who did not receive the proximal buttressing technique. All children's charts reviewed will be of patients who had their surgery at Children's Healthcare of Atlanta between December 1994 and August 2003; only information available up until October 10, 2003 will be used for this study. We will review approximately 75 charts for this study.
The first aim of the study would be to examine basic information regarding bleeding incidence. The following information will be collected on both groups:
- Amount of chest tube bleeding within the first 24 hours, and
- Number of patients who required re-exploration for bleeding
- Time from cardiopulmonary bypass removal to time leaving the operating room (indicator of the need to "dry up").
The second aim of the study would be to review the echocardiograms on these patients. The pulmonary valve size before the Ross procedure would be measured on the preoperative transthoracic or transesophageal echocardiogram. This would then be compared with postoperative studies in the Operating Room by transesophageal echocardiography. The pre-discharge echocardiogram and follow-up echocardiograms (which are a routine for these patients and, therefore, would not be necessary to add to the study protocol) would be reviewed. Autograft root diameters would be measured. The diameters would be at the level of the valve leaflets, at the level of the commissures and at the sinotubular ridge. These would be compared against published Z values for these patients by age, weight and body surface area. At the same time, any degree of aortic insufficiency or left ventricular outflow tract obstruction would be noted and recorded. One non-invasive cardiologist will review all old echocardiograms.
Study design
- Time perspective
- Retrospective
Who may qualify
- Ages
- Up to 21 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
- Study population
- Retro chart review
Key inclusion criteria (2 listed)
- Ross procedure with and without Proximal butressing technique
- Ross procedure between 12.1994 and 8.2003
Key exclusion criteria (1 listed)
- those who do not meet inclusion criteria
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study was stopped early. Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Jul 2011.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kirk R. Kanter, MD principal investigator
Children's Healthcare of Atlanta
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Congenital Disorders, run by Children's Healthcare of Atlanta at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 6 Jul 2011. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was stopped early. Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Jul 2011.