The Ross Procedure in Adults: Long-Term Follow-Up and Echocardiographic Changes Leading to Pulmonary Autograft Reoperation

Alessandro Frigiola, Marco Ranucci, Concetta Carlucci, Alessandro Giamberti, Raul Abella, Marisa Di Donato

Research output: Contribution to journalArticle

Abstract

Background: This is a clinical investigation of the mid- to long-term follow-up of the Ross procedure in adult patients. The primary end point is to explore the incidence and risk factors for a reoperation on the pulmonary autograft. The secondary end points are to explore the incidence of neoaortic root dilation and valve regurgitation, and the echocardiographic profile leading to a reoperation. Methods: Ross operations were done in 110 adults who received at least two echocardiographic examinations for a mean follow-up time of 82 months (range, 5 to 155 months). Kaplan-Meier and Cox regression analyses were applied to assess freedom from events and risk factors for events. Results: Freedom from reoperation on the pulmonary autograft, neoaortic root dilation, and moderate-severe neoaortic valve regurgitation were, respectively, 91.4%, 50%, and 70% at 12 years. The main risk factor for a reoperation was the degree of neoaortic valve regurgitation within the first 2 years of follow-up. Patients requiring an early (≤4 years) reoperation had early and severe pulmonary autograft valve regurgitation, and no neoaortic root dilation. Patients needing a late (>4 years) reoperation had severe neoaortic root dilation and severe neoaortic valve regurgitation. The left ventricular end-diastolic diameter at the third year of follow-up was a risk factor for late reoperation. Conclusions: The Ross operation in adults is a safe procedure with good clinical results in mid- to long-term follow-up. Early reoperations are due to early neoaortic valve regurgitation, wheras late reoperations are due to progressive neoaortic root dilation.

Original languageEnglish
Pages (from-to)482-489
Number of pages8
JournalAnnals of Thoracic Surgery
Volume86
Issue number2
DOIs
Publication statusPublished - Aug 2008

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Autografts
Reoperation
Lung
Dilatation
Pulmonary Valve Insufficiency
Incidence
Regression Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

The Ross Procedure in Adults : Long-Term Follow-Up and Echocardiographic Changes Leading to Pulmonary Autograft Reoperation. / Frigiola, Alessandro; Ranucci, Marco; Carlucci, Concetta; Giamberti, Alessandro; Abella, Raul; Di Donato, Marisa.

In: Annals of Thoracic Surgery, Vol. 86, No. 2, 08.2008, p. 482-489.

Research output: Contribution to journalArticle

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