Pulmonary Valve Function Late After Ross Procedure in 443 Adult Patients

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Valve Repair & Replacement

Background:

• Limited data exist on the long-term pulmonary valve function following the Ross procedure.
• The Ross procedure involves pulmonary valve replacement using a cryopreserved pulmonary allograft.

Purpose of the Study:

• To evaluate the long-term function of pulmonary valves in adult patients who underwent the Ross procedure.
• To determine the rates of reintervention and dysfunction of pulmonary allografts over time.

Main Methods:

• Retrospective review of 443 adult patients who underwent the Ross procedure between 1992 and 2018.
• Kaplan-Meier survival analysis to calculate freedom from adverse outcomes.
• Cox regression analysis to identify risk factors for valve failure.

Main Results:

• Excellent freedom from pulmonary allograft reintervention at 5, 10, 15, and 20 years (98.9%, 97.7%, 96.6%, 96.6%).
• High freedom from pulmonary allograft dysfunction (moderate regurgitation/stenosis or reintervention) at 5, 10, 15, and 20 years (94.5%, 88.1%, 84.9%, 78.3%).
• No identified risk factors influenced pulmonary valve durability.

Conclusions:

• Cryopreserved pulmonary allografts provide excellent long-term function in adults undergoing the Ross procedure.
• Reintervention on the pulmonary valve allograft is infrequent.
• Significant pulmonary allograft dysfunction is uncommon in the long term.