Long-term results of the Ross operation in adults

• Chernov I.I.
• Enginoev S.T.
• Аbdulmedzhidova U.K.
• Ziankou A.A.
• Gamzaev A.B.

Abstract

Aim. To analyze the experience of performing the Ross procedure in adult patients.

Material and methods. The retrospective study included 206 patients with AK pathology [154 men (74.8%)/52 women (25.2%)]. Inclusion criteria: patients who underwent the Ross operation from 2009 to 2019, the patient’s age is 18 years and older. Exclusion criteria none. The median age was 35 [26–44] years. Infective endocarditis as an AV dysfunction was diagnosed in 56 (27.2%) patients, and bicuspid AV in 125 (60.7%) patients. The median follow-up period was 94 [42–115] months.

Results. Combined interventions were performed in 38 (18.4%) cases. Modified techniques were applied in 23.3% of cases. The median duration of surgery was 220 [195–255] min, cardiopulmonary bypass – 138 [123–155] min, myocardial ischemia 115 [103–127] min. Hospital mortality was 0.5%. In the early postoperative period, implantation of a permanent pacemaker was indicated in 5 (2.4%) patients due to conduction disturbances. 9 (4.4%) patients developed perioperative myocardial injury, the number of strokes was 2 (1%). Ten-year overall survival, freedom from reoperation on a pulmonary autograft, freedom from reoperation on a pulmonary homograft was 95.6%, 87.8%, 96.5%, respectively. By the end of the observation period, the median of the peak and mean gradient on the lung autograft was 6 [4–8] and 3 [2–5] mm Hg and aortic regurgitation ≥2 degree was detected in 34 (17.8%) patients.

Conclusion. The Ross procedure is a safe alternative to AV replacement if performed by experienced specialists with acceptably low in-hospital mortality and excellent long-term outcomes.

Keywords:aortic stenosis; aortic regurgitation; acquired heart disease; aortic valve replacement; aortic valve; Ross operation

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