Ross Procedure for Aortic Valve Disease: 3 Years of Follow-Up

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Abstract

Background Pulmonary autograft replacement of the diseased aortic valve(Ross procedure) is an atractive alternative, particularly in young patients. Objective The aim of this study was to evaluate the early and mid-term results of this surgery in our institute. Material and method Between May 1995 and August 1998, 54 consecutive patients were included. Mean age was 34 ± 11years; 38patients (72%) were male. The indications of surgery were: severe aortic regurgitation 26 patients (48%), severe aortic stenosis 23 patients (42%), obstruction of the left ventricle outflow 1patient (2%), prosthetic dysfunction 1patient (2%), and acute endocarditis 3 patients (5%).In 40 patients the Ross operation was the unique technique and in 12 (22%) patients other procedures were performed. In surgery, the success of autograft valve implantation was monitored with transesophageal echo (TEE). Patients were follow-up an average of17 ±8 months (1 to38 months) with clinical contact and echo Doppler at 1, 3 and 6 months postoperative and then annually. Results In 2 patients the procedure failed (severe regurgitation in TEE monitoring during surgery) and this was due to a bicuspidpulmonary valve. Hospital mortality was 3.7%. At follow-up, the 51 hospital survivors were alive. One patient had reoperation due to symptomatic severe aortic regurgitation.Freedom from autograft replacement was 96.7% (CI:80.9%-100%) and freedom from endocarditis and thromboembolism 100%. The echocardiographic examination showed severe aortic regurgitation in 2 patients and moderate in another2. All patients remained asymptomatic.   Conclusion In our experience, Ross procedure is a technique with low hospital morbimortality and low rate of events at mid-term.