Introduction: The surgical strategy to manage multilevel left ventricular outflow tract diseases is changing constantly, however, the Ross-procedure has remained a standard method for 45 years. Aim: The aim of the study was to analyze early and mid-term results of Ross-procedure in congenital heart defects (single surgeon’s results). Methods: From 2001 until 2011 a total of 63 patients (age, 28 days–21 years; mean: 10 years, weight 3.4–96 kg; mean, 8.8 kg) underwent Ross (n = 40), Ross–Konno (n = 17) or Ross–Konno-mitral (n = 6) procedures. Indication for Ross procedure was aortic regurgitation in 15 patients (associated with ventricular septum defect in 8 patients) and a predominant aortic stenosis in 25 patients. 17 patients with severe left ventricular outflow tract obstruction underwent Ross–Konno procedure. 6 patients with concomitant mitral valve disease (Shone syndrome, 3 patients; complete atrioventricular septal defect, 3 patients) were reconstructed by Ross–Konno-mitral valve procedure. Results: Among Ross patients there were one early (cerebral complication) and one late death (homograft endocarditis) with a mean follow-up time of 7.4±1.8 years. Because of an early autograft endocarditis a 3-year-old boy underwent homograft implantation and was treated successfully with Bentall-procedure 9 years later. One patient with autograft regurgitation is waiting for reoperation. Among Ross–Konno patients there was no early or late death, and none of the patients underwent reoperation. In Ross–Konno-mitral patients there was one early death (28-day-old boy) and during a mean follow-up time of 2.5±1 years, and no reintervention or reoperation was needed in 5 patients. Conclusions: The results indicate a good outcome of Ross-, Ross–Konno-, Ross–Konno-mitral procedures in patients with congenital heart defects when surgery is performed by a highly experienced heart surgeon. In newborns, infants and small children Ross- and Ross–Konno procedures are the only methods for managing left ventricular outflow tract diseases. Concomitant severe mitral disease adds a high level of technical complexity to the Ross–Konno/mitral procedure, but it should be balanced against alternative strategies (eg. single ventricle palliation or transplantation). Orv. Hetil., 2013, 154, 219–224.
Surgery for transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction: European Congenital Heart Surgeons Association multicentre study
