Midterm Results of Ross Aortic Valve Replacement: A Single-Institution Experience

John Brown, Mark Ruzmetov, Ali Shahriari, Mark Rodefeld, Yousuf Mahomed, Mark Turrentine

Research output: Contribution to journalArticle

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Abstract

Background: We reviewed our institutional midterm experience to assess autograft and homograft hemodynamics and reoperative frequency after Ross aortic valve replacement. Methods: Between June 1993 and January 2009, 212 consecutive patients (mean age, 24.8 ± 15.5 years; range, 1 month to 67 years) underwent Ross aortic valve replacement; 49% were younger than 19 years old. One hundred forty-two additional procedures were required in 101 of the 212 patients (48%) at the time of the Ross aortic valve replacement. One hundred ninety-three patients had isolated aortic valve disease, and 19 pediatric patients had more complex, multilevel left ventricular outflow tract obstruction. Results: There were 2 early (1%) and 2 late deaths (1%), with a mean follow-up of 7.9 ± 4.2 years (range, 1 month to 15 years). Actuarial survival at 15 years was 98%. To date 28 patients (13%) have required reoperation. At 15 years, freedom from autograft sinus or ascending aortic dilatation was 79%, autograft dysfunction, 91%, autograft reoperation, 89%, and autograft replacement, 96%. Freedom from pulmonary allograft replacement was 96% at 15 years. Conclusions: The Ross aortic valve replacement can be performed in children and adults with good midterm results. The late complications of autograft regurgitation, sinus or ascending aortic dilatation, can usually be corrected with a valve-sparing root replacement. These complications can often be prevented by (1) aggressive treatment of postoperative systemic hypertension, (2) replacement of a dilated ascending aorta at the initial Ross procedure, or (3) external fixation of the autograft annulus or sinotubular junction. The potential of late autograft insufficiency, ascending aortic and sinus dilatation, or homograft stenosis and insufficiency warrants annual follow-up.

Original languageEnglish
Pages (from-to)601-608
Number of pages8
JournalAnnals of Thoracic Surgery
Volume88
Issue number2
DOIs
StatePublished - Aug 2009

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Autografts
Aortic Valve
Allografts
Dilatation
Reoperation
Ventricular Outflow Obstruction
Sinus of Valsalva
Aortic Diseases
Aorta
Pathologic Constriction
Hemodynamics
Pediatrics
Hypertension
Lung
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Midterm Results of Ross Aortic Valve Replacement : A Single-Institution Experience. / Brown, John; Ruzmetov, Mark; Shahriari, Ali; Rodefeld, Mark; Mahomed, Yousuf; Turrentine, Mark.

In: Annals of Thoracic Surgery, Vol. 88, No. 2, 08.2009, p. 601-608.

Research output: Contribution to journalArticle

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