Key result
The Ross procedure demonstrated normal pulmonary autograft function with a mean annual expansion of 0.15 to 0.40 mm and no pathological dilation 23 years postoperatively.
Why the study?
Although the Ross procedure offers widely known advantages, long-term studies have shown pulmonary autograft dilation in up to 20% of patients in the second postoperative decade.
Does the Ross procedure maintain normal pulmonary autograft and homograft function without pathological dilation 23 years after surgery in patients with bicuspid valves and endocarditis?
Case Report (n=3)
Does the Ross procedure maintain normal pulmonary autograft and homograft function without pathological dilation 23 years after surgery in patients with bicuspid valves and endocarditis?
The Ross procedure can provide excellent long-term hemodynamic results and durable autograft/homograft function without pathological dilation up to 23 years postoperatively.
Supports long-term durability in select cases; leaves open generalizability without prospective data.
INTRODUCTION: The Ross procedure plays a pivotal part in both congenital and acquired diseases of the aortic valve, especially in young patients. The advantages of this procedure are widely known; however, long-term studies have shown dilation of the pulmonary autograft (PA) in up to 20% of patients in the second decade postoperatively. METHODS: Three cases (ages 38, 51, and 53) who underwent the Ross procedure 23 years ago for bicuspid valves and endocarditis. Cases were followed-up with echocardiogram and computed tomography scan with three-dimensional reconstructions. RESULTS: The PA showed normal function with favorable geometry alongside the thoracic aorta, while the pulmonary homograft preserved its function with a low degree of calcification. The mean annual expansion of the autograft was only 0.15, 0.30, and 0.40 mm with no pathological dilation after 20 years DISCUSSION: Ross operation provides excellent hemodynamic results while avoiding long-term anticoagulation and might constitute a valid adjunct in selected categories such as young or endocarditis patients.
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Nappi et al. (2020) conducted a case report in Bicuspid aortic valve and endocarditis (n=3). Ross procedure was evaluated on Pulmonary autograft function and geometry. The Ross procedure demonstrated normal pulmonary autograft function with a mean annual expansion of 0.15 to 0.40 mm and no pathological dilation 23 years postoperatively.
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