Key result
Ross procedure yields ~95% 12-year survival in young adults, matching the general population.
Why the study?
The authors sought to evaluate their 12-year experience with the Ross procedure in adult patients.
What are the long-term survival and freedom from reoperation rates after the Ross procedure in young adult Russian patients compared with the general population?
Cohort (n=215)
No
What are the long-term survival and freedom from reoperation rates after the Ross procedure in young adult Russian patients compared with the general population?
In experienced surgical hands, the Ross procedure in young adults yields low early mortality (0.9%), 12-year survival comparable to the matched general population (94.7%), and high 11-year freedom from autograft (89.1%) and homograft (99%) reoperation.
Answers are grounded in this paper and cite their sources.
May inform shared decision-making for young adults; leaves open need for RCTs versus prosthetic valves.
Objectives: To evaluate our 12-year experience with the Ross procedure in adults. Methods: A retrospective analysis of 215 cases of the Ross procedure was performed. The mean age of the patients was 36 ± 11.1 years, and the male to female ratio was 75% to 25%, respectively. The pulmonary autograft was placed into the aortic position using the full-root replacement technique and its modified versions. The right ventricular outflow tract was reconstructed using a pulmonary homograft in all cases. Results: The 30-day mortality after the operation was 0.9% (2 patients). The median duration of follow-up was 6.1 years (interquartile range, 6.5 years) and was complete in 86% of cases. The survival at 12 years was 94.7% and was comparable with the survival rate of the general population matched for age and sex. At the end of the follow-up, freedom from reoperation due to pulmonary autograft and homograft dysfunction was 89.1% and 99%, respectively. Conclusions: In our series, the Ross procedure resulted in low early mortality and excellent survival in adults. The long-term survival was not statistically different from the survival of the general population. The pulmonary homograft offered an excellent durability and freedom from reoperation.
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Tsaroev et al. (2022) conducted a cohort in Aortic valve disease (stenosis, regurgitation, or mixed lesions) (n=215). Ross procedure (pulmonary autograft in aortic position via full-root replacement or modified Dacron graft/autologous inclusion techniques, with pulmonary homograft for RVOT reconstruction) vs. Age- and sex-matched general Russian population (for survival analysis) was evaluated on Survival at 12 years (95% CI 90.5%-99.0%, p=0.11). The Ross procedure in young adults resulted in a 12-year survival rate of 94.7% (95% CI 90.5%-99.0%), comparable to the age- and sex-matched general population (P=0.11).
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