Midterm echocardiographic follow-up after Ross operation

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Hemodynamic Monitoring

Background:

• The Ross operation is a viable treatment for aortic valve disease.
• Hemodynamic outcomes following the Ross operation require further definition.

Purpose of the Study:

• To evaluate the long-term hemodynamic performance of the pulmonary autograft in the aortic position and the pulmonary homograft in the pulmonary position after the Ross operation.

Main Methods:

• 132 patients underwent echocardiography up to 5 years post-Ross operation.
• Key metrics included effective orifice area (EOA), transvalvular gradients, and regurgitation for both aortic and pulmonary valves.
• EOA was indexed to body surface area.

Main Results:

• Excellent early hemodynamics were observed for both aortic and pulmonary valves.
• Aortic valve hemodynamics remained stable; pulmonary valve EOA and gradients significantly deteriorated within 6 months.
• 19.3% of patients exhibited suboptimal pulmonary valve hemodynamics, with 2% requiring further surgery for stenosis.

Conclusions:

• Pulmonary autografts provide sustained excellent aortic valve hemodynamics.
• Pulmonary homografts can develop moderately high gradients in some patients.
• Further research is needed to identify causes of pulmonary homograft deterioration and its clinical impact.