title: The Ross operation in children: 10-year experience.
abstract: BACKGROUND
  The Ross operation, first performed in children in 1968, may be the ideal aortic valve replacement. Technical demands of the operation and two valves at risk have delayed acceptance. A review of our experience to assess midterm and long-term results with the Ross operation is presented.
  
  
  METHODS
  The records of 150 consecutive patients, aged 7 days to 21 years (median age, 12 years, 75% less than 15 years) were reviewed. Follow-up was complete within the last 12 months (median, 2.8 years; range, 1 month to 10 years). Echocardiographic assessment was available on 116 (71%) within 1 year of closure and in 136 (91%) within 2 years.
  
  
  RESULTS
  Survival was 97.3% at 8 years. Late autograft valve dysfunction required replacement in 2 and reoperation with restitution of autograft function in 6. Freedom from reoperation for autograft dysfunction is 90% +/- 4% at 8 years. Freedom from reoperation for homograft obstruction is 94% +/- 3% at 8 years. Pulmonary homograft dysfunction (gradient > 40 mm Hg) was present in 4 additional patients. Freedom from reoperation on the homograft or a gradient of 40 mm Hg is 89% +/- 4% at 8 years. All patients have a normal, active lifestyle, without anticoagulants for their aortic valve replacement.
  
  
  CONCLUSIONS
  The Ross operation is the preferred operative replacement in children requiring aortic valve replacement.
authors.affiliation: Section of Thoracic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City 73190, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Elkins
authors.forename: C J
authors.initials: CJ
authors.lastname: Knott-Craig
authors.forename: K E
authors.initials: KE
authors.lastname: Ward
authors.forename: M M
authors.initials: MM
authors.lastname: Lane
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D011664:Pulmonary Valve / Q000637:transplantation*; D012086:Reoperation; D012189:Retrospective Studies; D014182:Transplantation, Autologous