Mid-term results of the Ross procedure

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Aortic Valve Replacement

Background:

• The Ross procedure, using a patient's own pulmonary valve to replace a diseased aortic valve, has a long history but its long-term efficacy requires further evaluation.
• Aortic valve disease affects a significant patient population, necessitating effective surgical solutions.

Purpose of the Study:

• To evaluate the long-term outcomes and safety of the Ross procedure in a large cohort of patients.
• To identify potential complications and factors influencing the success of the pulmonary autograft.

Main Methods:

• A retrospective review of 155 patients who underwent the Ross procedure between 1990 and 1999.
• Detailed analysis of implantation techniques, patient demographics, follow-up data, and echocardiographic findings.
• Complete follow-up, averaging 45 months, including Doppler echocardiography.

Main Results:

• Excellent survival rate of 98% at 7 years with only one operative and one late death.
• High freedom from severe aortic insufficiency (86% at 7 years) and reoperation (95% at 7 years).
• Dilation of the aortic annulus/sinotubular junction was the primary cause of aortic insufficiency, necessitating reoperation in one patient.

Conclusions:

• The Ross procedure demonstrates excellent short- and medium-term survival and functional results for aortic valve disease, particularly in younger patients.
• Progressive aortic insufficiency due to annular and sinotubular junction dilation is a potential long-term complication that requires monitoring.
• The pulmonary autograft provides a durable solution for many, with most patients remaining asymptomatic post-surgery.