Three years surgical and clinical experience with the Ross procedure in adults

From January 1991 to October 1994, 20 Ross procedures were performed. Mean age was 39.70 +/- 7.72 years, range 26 to 56 years. Male/female ratio was 14/6. Nineteen operations were elective, one was semiurgent. Predominant valvular lesion was stenosis in seven patients, aortic regurgitation in four, mixed disease in eight and prosthetic dysfunction in one patient. Twelve pulmonary autografts were implanted in the subcoronary (SC) position, eight as an intraaortic cylinder (inclusion technique (INCL)). Early mortality (< 30 days postoperative) was one (5.0%), there was no late mortality. Reoperation for valve failure occurred in two patients (10.0%). Additional CABG was performed in two patients (10.0%) for technical reasons. Major ECG changes were detected in five patients (three RBBB, two ischemia). No thromboembolic events were reported. Mean follow up was 21.2 months. Aortic insufficiency (AI) at one year was similar in the SC and INCL group. AI grade I in SC: 60%, in INCL: 60%; AI grade II in SC 10%, in INCL: 20%. At two years AI grade I occurred in 100% of the SC group. At three years AI grade I occurred in 75% of the SC group and AI grade II in 25%. No patients of the INCL group had two- or three-year follow up. At discharge slight pulmonary regurgitation was traced in only three patients and it remained stable during the follow up.(ABSTRACT TRUNCATED AT 250 WORDS)