Factors impacting long-term pulmonary autograft durability after the Ross procedure

For patients requiring intervention because of progressive disease of the aortic valve, the perfect palliation will provide a valve that produces normal dynamics of flow, will not require anti-coagulation, will grow with the patient, and have long term durability. Current surgical interventions include aortic valvoplasty, or replacement with either a mechanical or tissue prosthesis. Options for tissue valves include insertion of a pulmonary autograft in the Ross procedure, a cadaveric homograft, or porcine or bovine xenograft valves. The optimal option is still debated.

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Long-term Outcomes with the Pulmonary Autograft Inclusion Technique in Adults with Bicuspid Aortic Valves Undergoing the Ross Procedure

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2021.01.101 ◽

2021 ◽

Cited By ~ 1

Author(s):

Vaughn A. Starnes ◽

Ramsey S. Elsayed ◽

Robbin G. Cohen ◽

Anna P. Olds ◽

Markian M. Bojko ◽

...

Keyword(s):

Ross Procedure ◽

Long Term Outcomes ◽

Aortic Valves ◽

Pulmonary Autograft ◽

Bicuspid Aortic Valves

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Long-Term Clinical and Imaging Follow-Up After Reinforced Pulmonary Autograft Ross Procedure

Seminars in Thoracic and Cardiovascular Surgery Pediatric Cardiac Surgery Annual ◽

10.1053/j.pcsu.2015.11.005 ◽

2016 ◽

Vol 19 (1) ◽

pp. 59-62 ◽

Cited By ~ 16

Author(s):

Thierry Carrel ◽

Alexander Kadner

Keyword(s):

Ross Procedure ◽

Pulmonary Autograft

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

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2008.04.001 ◽

2008 ◽

Vol 86 (2) ◽

pp. 482-489 ◽

Cited By ~ 14

Author(s):

Alessandro Frigiola ◽

Marco Ranucci ◽

Concetta Carlucci ◽

Alessandro Giamberti ◽

Raul Abella ◽

...

Keyword(s):

Ross Procedure ◽

Pulmonary Autograft ◽

Long Term Follow Up

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Long Term Clinical and Echocardiographic Outcomes in Middle Aged Patients Undergoing the Ross Procedure

Structural Heart ◽

10.1080/24748706.2019.1587959 ◽

2019 ◽

Vol 3 (sup1) ◽

pp. 53-53

Author(s):

Jamie Romeo ◽

Grigorios Papageorgiou ◽

Francisco da Costa ◽

Hans Sievers ◽

Ad Bogers ◽

...

Keyword(s):

Ross Procedure ◽

Middle Aged ◽

Aged Patients

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Pulmonary Autograft Coronary-Cameral Fistula Leading to LVOT Pseudoaneurysm Post Ross Procedure

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135120938991 ◽

2020 ◽

pp. 215013512093899

Author(s):

Habib Jabagi ◽

Letizia Gardin ◽

Gyaandeo Maharajh

Keyword(s):

Left Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Left Ventricular ◽

Outflow Tract ◽

Ross Procedure ◽

Pulmonary Autograft ◽

Left Ventricular Outflow ◽

Coronary Cameral Fistula ◽

Coronary Cusp

We report the case of a presumed coronary-cameral fistula arising directly below the commissures of the noncoronary cusp (NCC) and left coronary cusp (LCC) of the pulmonary autograft, leading to left ventricular outflow tract pseudoaneurysm and late tamponade post Ross procedure.

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The Ross Procedure Revisited: Dacron Graft Reinforcement of the Pulmonary Autograft

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2013.07.598 ◽

2013 ◽

Vol 29 (10) ◽

pp. S350-S351

Author(s):

K. Kumar ◽

M. Al Aklabi ◽

I.M. Rebeyka ◽

D.B. Ross

Keyword(s):

Dacron Graft ◽

Ross Procedure ◽

Pulmonary Autograft

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Pulmonary Autograft Mitral Valve Replacement (Ross II): Long-Term Follow-Up of a US Center

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135118792196 ◽

2018 ◽

Vol 9 (6) ◽

pp. 645-650

Author(s):

David Blitzer ◽

Jeremy L. Herrmann ◽

John W. Brown

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Sudden Cardiac Arrest ◽

Right Heart Failure ◽

Atrioventricular Canal ◽

Pulmonary Autograft ◽

Atrioventricular Canal Defect

Background: Mitral valve replacement (MVR) with a pulmonary autograft (Ross II) may be a useful technique for pediatric and young adult patients who wish to avoid anticoagulation. Our aim was to evaluate the long-term outcomes of the Ross II procedure at our institution. Methods: Patients undergoing the Ross II procedure between June 2002 and April 2008 were included. Preoperative diagnoses included rheumatic disease (n = 5), congenital mitral valve (MV) pathology (partial atrioventricular canal defect [n = 2], complete atrioventricular canal defect [n = 1], Shone's complex [n = 1]), and myocarditis (n = 1). Results: Ten patients (eight females and two males) between 7 months and 46 years were included. Mean age at surgery was 25.2 ± 15.7 years. There were no in-hospital deaths. Mean follow-up was 11.7 ± 5.2 years. There were three late deaths at 11 months, 5 years, and 11 years, respectively. Causes of death included right heart failure, sepsis, and sudden cardiac arrest. Three patients required subsequent mechanical MVR a median of two years after the Ross II procedure (range: 1-4 years). There was no mortality with reoperation. Echocardiographic follow-up demonstrated mean MV gradients ranging from 2.2 to 9.6 mm Hg. Two patients had greater than mild MV regurgitation postoperatively, and all others had minimal mitral regurgitation or less. Two patients developed moderate MV stenosis. Conclusions: The Ross II procedure is an option for select older children and young adults desiring a durable tissue MVR to avoid long-term anticoagulation.

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Ross procedure and aortic valve repair: long-term echocardiographic outcomes, quality of life and physical activity of different aortic valve surgery procedures

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.409 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

F Bianco ◽

M Colaneri ◽

V Bucciarelli ◽

FC Surace ◽

FC Iezzi ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Aortic Valve ◽

Aortic Surgery ◽

Ross Procedure ◽

Valve Repair ◽

Sf 36

Abstract Funding Acknowledgements Type of funding sources: None. Background To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA). Methods In 2005-19, 129 patients (median age 22 [13, 33 IQR], 75% males) underwent aortic surgery in our Department: 40 were Ross (22 years [19, 51 IQR]), 67 AVr (17 years [1, 50 IQR]) and 22 aortic valve replacements (52 years [30, 80 IQR]). We focused on Ross and AVr. Retrospectively, relevant data were collected from medical records and phone re-calls. Physical activity (spontaneous and active) and QoL were assessed utilizing the IPAQ and SF-36 questionnaires. All patients underwent echocardiography pre/post-surgery and the follow-up lasted 12 ± 4 years. Results At the baseline, Ross patients had more aortic stenosis than insufficiency (P = 0.045). At the follow-up, Ross procedures presented more right-ventricle and aortic annulus dilatation (P = 0.002 and P = 0.030, respectively), but higher left-ventricular global longitudinal strain (LV GLS: 18 ± 3.2 % vs. 16 ± 3.3, P = 0.0027). Conversely, AVr experienced more re-do operations (Log-rank P = 0.005). Ross reported better QoL (SF-36: 0.8 ± 0.07 vs. 19 ± 0.4, P-0.045) and were also more active in daily PA (IPAQ ≥ 2500 Mets: 63.8% vs. 6%; P = 0.006). Ross patients practiced more sports activities than AVr (P = 0.011). Conclusions In a relatively small cohort of young and adults post aortic surgery patients, Ross procedures had better prognosis in terms of re-do operations; presented better ventricular function, as assessed by LV GLS. Ross patients had better long-term QoL and showed more spontaneous PA and involvement in sports activity.

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