Key result
At a mean of 8.1 years after the Ross procedure, patients had minor autograft and homograft dysfunction, normal biventricular systolic function (mean LV EF 63.1%), and good exercise capacity.
Why the study?
What are the long-term functional and imaging outcomes in adult patients who have undergone the Ross procedure?
Observational (n=45)
No
What are the long-term functional and imaging outcomes in adult patients who have undergone the Ross procedure?
Long-term follow-up after the Ross procedure shows minor autograft and homograft dysfunction but preserved biventricular function and good exercise capacity.
Supports favorable mid-term function after Ross in adults; leaves open durability and randomized comparisons.
OBJECTIVE: To assess autograft, homograft and ventricular function, as well as exercise capacity, in adult patients who have undergone the Ross procedure. SETTING: Single centre paediatric and adult congenital heart disease unit. Patients 45 subjects (24.6 years, range 16.9-52.2 years) who underwent the Ross procedure between 1994 and 2006 (8.1 years after the Ross operation, range 2.0-14.0 years). Interventions Cardiovascular magnetic resonance imaging, echocardiography and cardiopulmonary exercise testing. MAIN OUTCOME MEASURES: Autograft and homograft stenosis, and regurgitation. Autograft size. Biventricular function, scar volume and exercise capacity. RESULTS: Mean autograft regurgitation was 6.8%+/-8.3% (trivial regurgitation) and diameter was 40.0+/-7.0 mm. Mean homograft velocity was 2.4+/-0.6 m/s (mild-moderate stenosis) and regurgitation was 6.1%+/-8.3% (trivial regurgitation). Biventricular systolic function was normal (LV EF 63.1+/-6.4% and RV EF 60.1%+/-7.6%). In 38% of cases there was evidence of LV scar, mostly noted within the inter-ventricular septum. The mean exercise capacity achieved was 87%+/-22% of predicted. There was no correlation between exercise capacity and ventricular function or scar. CONCLUSION: This study demonstrates minor autograft and homograft dysfunction in the majority of patients after the Ross procedure, associated with good ventricular function and exercise capacity. In addition, minor scar was present in a third of patients with no functional consequences.
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Puranik et al. (2009) conducted an observational in Post-Ross procedure (n=45). Ross procedure was evaluated on Autograft and homograft stenosis and regurgitation, autograft size, biventricular function, scar volume, and exercise capacity. At a mean of 8.1 years after the Ross procedure, patients had minor autograft and homograft dysfunction, normal biventricular systolic function (mean LV EF 63.1%), and good exercise capacity.
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