Valve-sparing operations after Ross procedure: a single-center experience.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Valve Surgery

Background:

• The Ross procedure offers excellent long-term outcomes for severe aortic valve dysfunction, restoring life expectancy.
• Reintervention may be necessary after the Ross procedure, necessitating evaluation of redo surgery outcomes.

Purpose of the Study:

• To describe the center's experience with redo surgery following prior Ross procedures.
• To evaluate survival, freedom from reoperation, and freedom from significant aortic regurgitation after redo surgery post-Ross.

Main Methods:

• A prospective database search identified adult patients undergoing valve-sparing root replacements and/or aortic valve repair after a Ross procedure (July 2001-July 2022).
• Univariable logistic regression analyzed factors affecting early mortality.
• Kaplan-Meier methods assessed survival, freedom from reintervention, and freedom from grade ≥3 aortic regurgitation.

Main Results:

• Sixty-three patients were included, with indications for reoperation including aortic aneurysm with or without regurgitation, and isolated aortic regurgitation.
• Median follow-up was 7.82 years; 76% had undergone the free root technique during the initial Ross operation.
• 10-year survival was 92.4%, and 10-year freedom from reoperation on the aortic valve was 79.7%.

Conclusions:

• Redo surgery following the Ross procedure is associated with excellent long-term survival.
• The findings support an aggressive valve-sparing strategy in the context of repeat aortic valve surgery after a Ross procedure.