The Ross Procedure in Active Infective Endocarditis: A Comparison With Conventional Prostheses

Area of Science:

• Cardiovascular Surgery
• Infective Diseases
• Prosthetic Valve Surgery

Background:

• The Ross procedure is considered for infective endocarditis (IE) due to potential resistance to infection.
• Limited comparative data exists between the Ross procedure and conventional prostheses in IE patients.

Purpose of the Study:

• To compare the outcomes of the Ross procedure versus conventional aortic valve surgery in patients with infective endocarditis.
• To evaluate the efficacy and safety of the Ross procedure in the context of IE.

Main Methods:

• A retrospective study comparing 25 patients undergoing the Ross procedure for IE (Ross group) with 37 patients undergoing other aortic valve procedures for IE (other group).
• Data collected on patient demographics, surgical complexity, short-term outcomes, reoperation rates, and composite events.

Main Results:

• The Ross group had higher rates of intravenous drug use, prosthetic valve endocarditis, and annular abscesses.
• Despite longer bypass and cross-clamp times, short-term outcomes were similar. The Ross group had significantly lower reoperation rates (4% vs. 16%) and fewer composite events (P = .04).
• Multivariable analysis identified the Ross procedure as an independent protective factor against composite endpoints (P = .03).

Conclusions:

• The Ross procedure offers comparable short-term outcomes to other aortic valve procedures in IE patients, despite increased surgical complexity.
• In the midterm, the Ross procedure demonstrates a lower reoperation rate and significantly fewer composite events, suggesting it may be a favorable option for IE.
• Long-term follow-up is essential to fully ascertain the benefits of the Ross procedure in infective endocarditis.