The Ross Procedure: current registry results

The pulmonary autograft procedure for the treatment of aortic valve disease was developed and performed by Ross in 1967. The results he published in 1987 prompted increasing interest in the procedure. The International Registry of the Ross Procedure was established in 1993 to further examine longitudinal clinical outcomes.

The results from the Ross registry document the continued and growing interest in the procedure with 2,523 patients currently enrolled, representing 122 centers and 166 surgeons worldwide.

Mortality (1987 to present) reported in the registry is 2.5%. It should be noted that follow-up stands at 70%. The most important issues for the registry to track are the incidence of reoperation for autograft failure and the fate of the pulmonary homograft. Reoperation for all valve-related problems is low (5.4%), with an autograft explant rate of 1.9%. Overall registry data indicate that the right ventricular outflow tract revision rate is 2.8%, with this decreasing by half to 1.3% in the 1987 to present subgroup.

Rigorous analysis of outcomes is difficult with registry follow-up currently at 70%; however, the general conclusions derived from the registry are supported by other individual series with excellent follow-up. Success of the registry depends on judicious efforts by all participating surgeons and coordinators in documenting long-term patient results and reporting them to the registry.