Results of a Multimodal Approach for the Launch of a Ross Program

There has been renewed interest in the Ross procedure in young patients with aortic valve disease. We describe the details and results of a systematic strategy to launch a new Ross program.

Our department developed a multidisciplinary educational program that involved all practitioners involved in the care of potential Ross patients. A core group of surgeons underwent extensive hands-on technical preparation. Selection of patients was reviewed by a multidisciplinary team. Patient characteristics, operative details, and postoperative outcomes were analyzed.

Between March 2021 and March 2022, 22 consecutive patients underwent Ross procedure at our institution. The mean age of the patients at time of operation was 40.4 ± 10.2 years, and most patients had no medical comorbidities (12/22). The most common indication for operation was aortic stenosis (13/22), followed by mixed aortic stenosis and aortic insufficiency (7/22). There were no deaths. Postoperatively, no patient required blood transfusion or reexploration for hemorrhage. All patients were discharged home on mean hospital day 5.9 ± 1.1. On predischarge echocardiography, there was a significant reduction in mean aortic gradients preoperatively to postoperatively (49 ± 20 mm Hg vs 4 ± 1 mm Hg; P < .01) without aortic insufficiency or a change in left or right ventricular function.

We demonstrate that with multidisciplinary education and extensive hands-on surgical preparation under proctored supervision, a Ross program can be initiated safely with excellent short-term results and perioperative risk that mimics that of conventional surgical aortic valve replacement.