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Updated: May 5, 2026

A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position
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The Ross Operation in Young Patients—A Single-Center, Long-Term Follow-Up Study.

Markus Liebrich1, Christoph Dingemann, Detlef Roser

  • 1Department of Cardiac Surgery, Heart Center Stuttgart, Klinikum Stuttgart, Stuttgart, Germany; Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany.

Deutsches Arzteblatt International
|October 8, 2024
PubMed
Summary

The Ross operation offers excellent long-term survival for young patients needing aortic valve replacement. This surgical option demonstrates low reoperation rates and adverse events, making it an effective treatment for aortic valve disease.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Valve Disease Management

Background:

  • Standard aortic valve replacement options for young patients include bioprosthetic and mechanical valves.
  • The Ross operation, using the patient's own pulmonary valve to replace the aortic valve, is an alternative surgical approach.
  • This study evaluates the long-term outcomes of the Ross operation in a young patient cohort.

Purpose of the Study:

  • To present the long-term results of the Ross operation with root replacement in young patients.
  • To assess overall survival, re-operation/reintervention rates, and serious adverse events.
  • To compare the efficacy of the Ross operation against standard aortic valve replacement procedures in this demographic.

Main Methods:

  • The Ross operation with root replacement was performed on 795 patients between 1995 and 2020.
  • Data collection focused on overall survival, autograft and homograft/RV-PA conduit re-operation/reintervention rates, and adverse events.
  • Follow-up was 96% complete, covering 9540 patient-years with a mean follow-up of 12 ± 7 years.

Main Results:

  • 795 patients (mean age 43 ± 14 years) underwent the procedure; 30-day mortality was 1%.
  • Survival rates at 20 years were 86% for overall survival, 80% for autograft survival without reoperation, and 85% for homograft/RV-PA conduit survival without reoperation.
  • Low rates of hemorrhage (5), thromboembolic complications (14), and endocarditis (19) were reported.

Conclusions:

  • The Ross operation with root replacement demonstrates high survival rates exceeding 25 years.
  • The procedure is associated with low rates of reoperation, reintervention, morbidity, mortality, and endocarditis.
  • The Ross operation is an effective surgical treatment for young patients with aortic valve disease.