Ross procedure in congenital patients: results and left ventricular function

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Thoracic Surgery

Background:

• Aortic valve replacement is a critical procedure for patients with severe aortic valve disease.
• The Ross procedure, using autografts, offers an alternative to traditional prosthetic valves.
• Assessing the impact of the Ross procedure on left ventricular (LV) function is crucial for understanding long-term outcomes.

Purpose of the Study:

• To evaluate the safety and efficacy of the Ross procedure for aortic valve replacement.
• To assess the impact of the Ross procedure on left ventricular dimensions, mass, and function.
• To determine the recovery of left ventricular function after aortic valve replacement with autografts.

Main Methods:

• A cohort of 121 patients underwent aortic valve replacement between 1990 and 1995.
• Fifty-two patients received autografts, including 24 Ross procedures for congenital conditions since 1991.
• Transthoracic and intraoperative transesophageal echocardiography were used to assess aortic and pulmonary annuli, gradients, incompetence, and LV function.

Main Results:

• One early death (4%) occurred; no late deaths were observed.
• All survivors were in NYHA class I, free of complications and medications, with no significant aortic regurgitation or gradients.
• LV dimensions normalized within 1-3 months post-surgery, and LV mass and wall stress decreased, indicating improved LV function in most patients.

Conclusions:

• The Ross procedure is a safe and effective method for aortic valve replacement.
• This technique successfully eliminates abnormal LV loading conditions.
• Complete recovery of LV function is achievable in the majority of patients following the Ross procedure.