Minimally Invasive Ross Procedure in Adults, Through an Arrow-Shaped ("V" Shaped) Ministernotomy Approach

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• The Ross procedure offers excellent long-term aortic valve surgery outcomes, including hemodynamic performance and freedom from anticoagulation.
• Minimally invasive approaches aim to reduce surgical trauma and improve recovery.

Purpose of the Study:

• To evaluate the technical feasibility and early clinical outcomes of the Ross procedure via a minimally invasive V-shaped partial sternotomy in adult patients.

Main Methods:

• Eleven adult patients underwent the Ross procedure using a 7 cm V-shaped ministernotomy.
• Cardiopulmonary bypass was established via central cannulation.
• Pulmonary autograft and homograft implantation were performed using the miniroot technique.

Main Results:

• All procedures were successful without conversion to full sternotomy or major complications.
• Average cardiopulmonary bypass and aortic cross-clamp times were 144 and 86 minutes, respectively.
• No major adverse events (stroke, renal failure, mortality) occurred; patients were discharged 7-10 days post-op.

Conclusions:

• The V-shaped partial sternotomy is technically feasible for the Ross procedure in selected adults.
• This minimally invasive approach provides adequate exposure while retaining surgical advantages.
• Further studies with longer follow-up are needed to confirm long-term outcomes.