title: Ross operation for active culture-positive aortic valve endocarditis with extensive paravalvular involvement.
abstract: BACKGROUND
  We evaluated the midterm results of the Ross operation in active advanced endocarditis.
  
  
  METHODS
  Between June 1994 and June 2000 a pulmonary autograft aortic root replacement was performed in 11 consecutive patients who had urgent or emergent procedures for active endocarditis with extensive involvement of the aortic root (10 native, 1 prosthetic). Patients ranged in age from 26 to 45 years (median, 33 years). Indications for operation were uncontrolled infection (n = 5), hemodynamic deterioration (n = 3), or both (n = 3). Four patients were in the New York Heart Association class III, 6 in class IV, and 1 was operated on while in cardiogenic shock. Four patients (36%) suffered an embolic cerebrovascular accident preoperatively. The endocarditis affected the mitral valve in 2 patients and the tricuspid valve in 1 patient.
  
  
  RESULTS
  There was no early or late death. Recurrent endocarditis was not detected in any of the patients during the follow-up period ranging up to 72 months (median, 40 months).
  
  
  CONCLUSIONS
  The autograft may well be the best substitute for aortic root reconstruction in advanced endocarditis.
authors.affiliation: Department of Cardiac Surgery, Cardiologic Hospital, University of Lille, France. aprat@chru-lille.fr
authors.forename: A
authors.initials: A
authors.lastname: Prat
authors.forename: J I
authors.initials: JI
authors.lastname: Saez de Ibarra
authors.forename: A
authors.initials: A
authors.lastname: Vincentelli
authors.forename: C
authors.initials: C
authors.lastname: Decoene
authors.forename: O H
authors.initials: OH
authors.lastname: Fabre
authors.forename: B
authors.initials: B
authors.lastname: Jegou
authors.forename: C
authors.initials: C
authors.lastname: Savoye
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000382:microbiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D014463:Ultrasonography