The Ross operation: a Trojan horse?†
Open Access
- 15 February 2007
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal
- Vol. 28 (16), 1993-2000
- https://doi.org/10.1093/eurheartj/ehl550
Abstract
The Ross operation is the operation of choice for children who require aortic valve replacement (AVR) and may also provide a good option in selected adult patients. Although the autograft does not require anticoagulation and has a superior haemodynamic profile, concern regarding autograft and allograft longevity has risen. In this light, we report the 13-year results of our prospective autograft cohort study. Between 1988 and 2005, 146 consecutive patients underwent AVR with a pulmonary autograft at Erasmus Medical Center Rotterdam. Mean age was 22 years (SD 13; range 4 months–52 years), 66% were male. Hospital mortality was 2.7% (N = 4); during follow-up four more patients died. Thirteen-year survival was 94 ± 2%. Over time, 22 patients required autograft reoperation for progressive neo-aortic root dilatation. In addition, eight patients required allograft reoperation. Freedom from autograft reoperation at 13 years was 69 ± 7%. Freedom from allograft reoperation for structural failure at 13 years was 87 ± 5%. Risk factors for autograft reoperation were previous AVR and adult patient age. Although survival of the Rotterdam autograft cohort is excellent, over time a worrisome increase in reoperation rate is observed. Given the progressive autograft dilatation, careful follow-up of these patients is warranted in the second decade after operation.Keywords
This publication has 24 references indexed in Scilit:
- Degeneration of the pulmonary autograft: An explant studyThe Journal of Thoracic and Cardiovascular Surgery, 2006
- A Critical Reappraisal of the Ross OperationCirculation, 2006
- Percutaneous Pulmonary Valve Implantation in HumansCirculation, 2005
- The Ross procedure: Long-term clinical and echocardiographic follow-upThe Annals of Thoracic Surgery, 2004
- Report of the Dutch experience with the Ross procedure in 343 patientsEuropean Journal of Cardio-Thoracic Surgery, 2002
- Dilation of the pulmonary autograft after the ross procedureThe Journal of Thoracic and Cardiovascular Surgery, 2000
- Guidelines for reporting morbidity and mortality after cardiac valvular operationsThe Journal of Thoracic and Cardiovascular Surgery, 1996
- Homograft root replacement for juvenile rheumatoid aortic valve incompetenceThe Annals of Thoracic Surgery, 1992
- REPLACEMENT OF AORTIC AND MITRAL VALVES WITH A PULMONARY AUTOGRAFTThe Lancet, 1967