Late results of the Ross procedure

The study objective was to examine the long-term results of the Ross procedure in a cohort of patients followed prospectively for more than 2 decades. From 1990 to 2004, 212 consecutive patients with a median age (interquartile range) of 34 years (28-41) underwent the Ross procedure; 82% had congeni...

Full description

Saved in:

Bibliographic Details
Published in:	The Journal of thoracic and cardiovascular surgery 2019-01, Vol.157 (1), p.201-208
Main Authors:	David, Tirone E., Ouzounian, Maral, David, Carolyn M., Lafreniere-Roula, Myriam, Manlhiot, Cedric
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Allografts Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Insufficiency - congenital Aortic Valve Insufficiency - surgery aortic valve replacement Autografts Echocardiography Female Humans Male Middle Aged Pulmonary Valve - transplantation Reoperation Ross procedure Time Factors Treatment Outcome Young Adult
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	The study objective was to examine the long-term results of the Ross procedure in a cohort of patients followed prospectively for more than 2 decades. From 1990 to 2004, 212 consecutive patients with a median age (interquartile range) of 34 years (28-41) underwent the Ross procedure; 82% had congenital aortic valve disease. The technique of aortic root replacement was used in one half of the patients. Patients have been followed prospectively for a median (interquartile range) of 18.0 (14.6-21.2) years. Valve function was assessed by echocardiography. Cumulative mortality at 20 years was 10.8% (95% confidence interval, 6.5-17.8). Thirty patients required Ross-related reoperations and 3 for coronary artery disease. The cumulative probability of Ross-related reoperations at 20 years was 16.8% (95% confidence interval, 11.3-24.5), on the pulmonary autograft was 11.5% (95% confidence interval, 7.2-18.0), and on the pulmonary homograft was 8.2% (4.6-14.7). The implantation technique was not associated with the cumulative incidence of reoperations on the pulmonary autograft. The development of moderate or severe aortic insufficiency and pulmonary homograft dysfunction increased with time. At 20 years, the probability of aortic insufficiency was 13% (95% confidence interval, 8.0-20.3) and of pulmonary homograft dysfunction was 19.7% (95% confidence interval, 13.9-27.2). Preoperative aortic insufficiency was associated with increased odds of postoperative aortic insufficiency. The long-term results of the Ross procedure are excellent regardless of the implantation technique, but there is a progressive deterioration of function of both semilunar valves.
ISSN:	0022-5223 1097-685X