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Mid-Term Results of Ross Procedure: Our Limited Experience

Department of Cardiothoracic Surgery, St. Vincents Hospital, Sydney, Australia

For reprint information contact: Alan Farnsworth, FRCS Tel: 61 2 8382 6868 Fax: 61 2 8382 6869 Email: aefarnsworth{at}stvincents.com.au, Suite 811, St. Vincents Clinic, St. Vincents Hospital, Sydney, 438 Victoria Street, Darlinghurst, New South Wales 2010, Australia.

From February 1995 to February 2005, 30 patients underwent the Ross procedure with the root replacement technique. There were 20 males (66.7%) and 10 females (33.3%), aged 13 to 49 years. The diagnosis was aortic stenosis in 12 patients (40%), aortic regurgitation in 10 (33%), mixed stenosis and regurgitation in 6 (20%), prosthetic endocarditis with an aortic root abscess in 1 (3.3%), and a perivalvular leak in 1 (3.3%). There was no early or late death. Six patients (20%) suffered 7 significant operative complications. Over a median follow-up of 65 months (range, 4–114 months), there were 3 re-operations for autograft failure and 2 for homograft failure. No patient experienced a cerebrovascular accident, and all but one were free from endocarditis. Freedom from autograft failure was 94.1% ± 5.7% at 5 years and 79.5% ± 10.7% at 8 years, while freedom from homograft failure was 96.6% ± 3.4% at 5 years and 88.5% ± 8.3% at 8 years. Our midterm results show that good early and late survival can be obtained in young patients with aortic valve disease. Re-exploration for bleeding and late autograft failure are the main concerns of this challenging operation, especially early in the surgeon’s learning-curve.