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Mid-term Outcomes of the Ross II Procedure in Infants and Young Children with Irreparable Mitral Disease

Qiyu He1, Xinjie Lin1, Huaping Jiang1

  • 1Paediatric Cardiac Surgery Centre, National Clinical Research Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Centre for Cardiovascular Diseases, Beijing 100037, China.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|October 23, 2025
PubMed

Insights

The Ross II procedure in young children showed a high rate of mitral stenosis, a significant complication. However, it may be a viable option when prosthetic valves are unavailable.

Area of Science:

  • Pediatric Cardiac Surgery
  • Valvular Heart Disease
  • Autograft Procedures

Background:

  • The Ross II procedure involves using the pulmonary autograft to replace the aortic valve and the native pulmonary valve to replace the mitral valve.
  • Limited data exists on the long-term outcomes of the Ross II procedure in infants and young children.

Purpose of the Study:

  • To summarize the clinical implications and outcomes of the Ross II procedure in pediatric patients.
  • To evaluate the safety and efficacy of the Ross II procedure in a young population.

Main Methods:

  • Retrospective review of pediatric patients who underwent the Ross II procedure between 2011 and 2022.
  • Analysis of baseline, operative, and postoperative characteristics, including all-cause mortality and reoperation rates.
  • Median follow-up of 36 months.

Main Results:

  • Ten patients underwent the Ross II procedure, with a median age of 1.8 years at surgery.
  • Two cases of late mortality and three reoperations were recorded.
  • Mitral stenosis was a predominant late complication, affecting 80% of patients, with prolonged intensive care unit and hospital stays observed.

Conclusions:

  • The Ross II procedure may be a safe alternative for infants and young children when prosthetic valves are not accessible.
  • The limited growth potential of the pulmonary autograft is a consideration for long-term outcomes.
Abstract

Keywords:
Ross II procedurecongenital mitral valve disease

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