Subcoronary Ross procedure in patients with active endocarditis

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Valvular Heart Disease

Background:

• The Ross procedure is an increasingly favored alternative to prosthetic aortic valves.
• Pulmonary autografts offer theoretical advantages against infection, making them suitable for active endocarditis.

Purpose of the Study:

• To evaluate the efficacy of the Ross procedure in patients with active native valve endocarditis.
• To assess the outcomes, including mortality, morbidity, and recurrence of endocarditis, following the Ross procedure.

Main Methods:

• The Ross procedure, using subcoronary and inclusion techniques, was performed on 296 patients between 1994 and 2003.
• Twenty patients presented with active aortic valve endocarditis at the time of surgery.
• Clinical and echocardiographic follow-up was completed for all patients.

Main Results:

• Early mortality was 1%, with no late mortality observed.
• No recurrence of endocarditis or neurological events occurred during a mean follow-up of 47.3 months.
• Patients exhibited excellent functional status (NYHA class I) with stable autograft function and minimal homograft regurgitation.

Conclusions:

• The Ross procedure, utilizing subcoronary and inclusion techniques, is an effective treatment for native valve endocarditis.
• This surgical approach is associated with low mortality, morbidity, and a very low endocarditis recurrence rate.