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Ross operation in the young: a ten-year experience
Giovanni Battista Luciani1, Alessandro Favaro, Gianluca Casali
1Division of Cardiac Surgery, University of Verona, Verona, Italy. gbluciani@yahoo.com
The Annals of Thoracic Surgery
|November 25, 2005
Summary
The Ross operation offers excellent survival and quality of life for young patients needing aortic valve replacement. However, long-term monitoring for autograft dilatation and homograft stenosis is crucial for optimal outcomes.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Thoracic Surgery
Background:
- The Ross operation is a viable alternative to mechanical aortic valve replacement in pediatric and young adult populations.
- While effective, the procedure has been associated with early and late complications requiring careful evaluation.
Purpose of the Study:
- To assess the 10-year clinical experience and outcomes of the Ross operation in children and young adults.
- To identify factors influencing the durability and potential complications of the autograft and homograft.
Main Methods:
- A review of 10-year clinical data from 112 patients (aged 6-49 years) who underwent the Ross operation.
- Cross-sectional clinic and echocardiographic examinations were performed, focusing on survival, autograft/homograft function, and reoperation rates.
Main Results:
- Ten-year survival was excellent at 98%.
- Late autograft dilatation occurred in 29% of patients, with 10-year freedom from dilatation at 43%.
- Reoperation was required in 10% of patients, with 10-year freedom from reoperation at 72%.
Conclusions:
- The Ross procedure demonstrates excellent long-term survival and quality of life.
- Increasing prevalence of late autograft dilatation, regurgitation, and homograft stenosis necessitates ongoing surveillance.
- Technical modifications and timely interventions may improve the long-term durability of the autograft.