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Updated: May 8, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Published on: March 28, 2025

Ross Procedure After Arterial Switch Operation?

Sahithi Bhavana1, Rachel Johnstone2, Wasim Khan3

  • 1Department of Pediatric Cardiothoracic Surgery, Heart and Vascular Center, Akron Children's Hospital, Akron, Ohio.

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
|May 6, 2026
PubMed
Summary
This summary is machine-generated.

The Ross procedure offers a viable solution for severe neo-aortic regurgitation after arterial switch operation (ASO) in D-transposition of the great arteries (d-TGA). Annular stabilization is crucial for the long-term success of this approach.

Keywords:
ASORossneo-aortic dilatationneo-aortic regurgitationpost-ASO complications

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Published on: December 11, 2017

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Area of Science:

  • Cardiovascular Surgery
  • Congenital Heart Disease
  • Cardiac Valve Repair

Background:

  • Arterial switch operation (ASO) is standard for D-transposition of the great arteries (d-TGA), but late complications like neo-aortic regurgitation (neo-AR) and root dilatation (ARD) can necessitate reoperation.
  • Management of neo-AR depends on whether it's leaflet- or root-driven, with options including valve-sparing root replacement or composite root replacement.
  • The Ross procedure is an alternative for isolated neo-AR without significant ARD, though less commonly used post-ASO.

Purpose of the Study:

  • To review the Ross procedure as a treatment for neo-aortic regurgitation (neo-AR) following arterial switch operation (ASO).
  • To emphasize operative techniques, potential complications, and durability of the Ross procedure in this specific patient population.
  • To highlight the importance of annular stabilization for long-term success, illustrated by a case study.

Main Methods:

  • Literature review focusing on the Ross procedure after ASO for neo-AR.
  • Case illustration of a 19-year-old patient with severe neo-AR and mild ARD post-ASO who underwent a 'supported' Ross procedure with external annuloplasty.
  • Analysis of operative pearls, complications, and durability considerations.

Main Results:

  • The 'supported' Ross procedure with external annuloplasty was successfully performed in the case study, with an uneventful recovery.
  • This approach demonstrated feasibility for managing severe neo-AR when valve repair is insufficient.
  • Annular stabilization was identified as a key factor for achieving long-term success.

Conclusions:

  • The Ross procedure, particularly with annular stabilization, is a feasible and potentially durable option for patients experiencing severe neo-aortic regurgitation after arterial switch operation.
  • This approach addresses limitations of standard valve repair in selected post-ASO patients.
  • Further research and case documentation are valuable for this less common but important surgical strategy.