The Ross Procedure
- 1 September 2004
- journal article
- review article
- Published by Hindawi Limited in Journal of Cardiac Surgery
- Vol. 19 (5), 401-409
- https://doi.org/10.1111/j.0886-0440.2004.04080.x
Abstract
The search for the ideal substitute for the aortic valve led Donald Ross to develop the pulmonary autograft concept in 1967. A historical, technical, and scientific review of this surgical option is presented together with our clinical experience.The literature is reviewed to identify the advantages and pitfalls of the Ross procedure over the last decades. We also present our clinical experience with 92 patients operated between 1997 and May 2003.Of the total, 70.65% (n = 65) were males, mean age was 29.32 +/- 11.9 years, with 20 patients under 16 and 6 patients under 10 years. Twenty-five patients (27.17%) had 31 previous interventions. There were 41 associated procedures in 34 patients. Perioperative mortality was 2.17% (two patients). Eight patients required reexploration for bleeding, one required an aortocoronary bypass, and one a permanent pacemaker. Follow-up was 97% with 2.71 patients/year (average 32.55 +/- 19.01 months). Two patients required autograft replacement, one suffered a 44-mm dilatation of the autograft, and one 13-year-old girl developed autograft endocarditis. Six patients suffered severe homograft stenosis (>50 mmHg), two were treated percutaneously, and one required replacement. Combined freedom from reintervention is 93.56 +/- 2.81% at 5 years.The Ross procedure is a mature concept with thousands of patients operated worldwide and a cumulative experience of over 30 years. Although we believe that it is the procedure of choice in the pediatric population, women in child-bearing age, and substantial subgroups of adult patients, efforts must continue to minimize the incidence of auto- and homograft failure in the long term.Keywords
This publication has 28 references indexed in Scilit:
- Subcoronary implantation or aortic root replacement for human tissue valves: Sufficient data to prefer either technique?The Annals of Thoracic Surgery, 1995
- Medium-term follow-up of pulmonary autograft replacement of aortic valves in childrenEuropean Journal of Cardio-Thoracic Surgery, 1994
- Pulmonary Autograft: An American ExperienceJournal of Cardiac Surgery, 1987
- Long-term Assessment of Aortic Valve Replacement with Autologous Pulmonary ValveThe Annals of Thoracic Surgery, 1985
- Biomechanics of the pulmonary autograft valve in the aortic position.Thorax, 1982
- Homograft replacement of aortic root with reimplantation of coronary arteries. Results after one to five years.Heart, 1982
- Autologous Pulmonary Valve Replacement of the Diseased Aortic ValveCirculation, 1970
- Aortic Homograft Valve ReplacementCirculation, 1969
- REPLACEMENT OF AORTIC AND MITRAL VALVES WITH A PULMONARY AUTOGRAFTThe Lancet, 1967
- HOMOGRAFT REPLACEMENT OF THE AORTIC VALVEThe Lancet, 1962