A single-center experience with the ross procedure over 20 years

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Thoracic Surgery

Background:

• The Ross procedure is a complex aortic valve replacement technique with potential benefits for young patients.
• Concerns regarding pulmonary homograft stenosis and autograft dilatation limit its widespread adoption.
• Long-term outcomes, including mortality and reintervention rates, require further investigation.

Purpose of the Study:

• To evaluate the long-term outcomes of the Ross procedure in a single center.
• To assess mortality and the need for valvular reintervention after the Ross procedure.
• To determine the efficacy of the Ross procedure in a pediatric and adult patient population.

Main Methods:

• A retrospective analysis of patients who underwent the Ross procedure (modified Yacoub technique) between 1991 and 2011.
• Descriptive statistical methods and Kaplan-Meier analyses were employed for data assessment.
• Median follow-up was 10 years, with detailed tracking of mortality and reintervention events.

Main Results:

• 246 patients (176 adults, 70 pediatric) underwent the procedure, with a median follow-up of 10 years.
• Early mortality was 1.6%; overall mortality was comparable to age- and sex-matched populations.
• Freedom from reintervention was 95% at 5 years, 88% at 10 years, and 81% at 15 years, with a linearized reoperation risk of 0.6% for both autograft and RVOT.

Conclusions:

• The Ross procedure demonstrates favorable early results and excellent long-term survival.
• It is an effective aortic valve replacement method for children and young adults.
• Root reinforcement and aortic reduction plasty may enhance outcomes, particularly in adults with aortic regurgitation.