The Ross II procedure: pulmonary autograft in the mitral position.
The surgical management of mitral valve disease in women of childbearing age, young patients, and children with congenital mitral valve defects is made difficult by the prospect of lifelong anticoagulation. We suggest the use of a pulmonary autograft in the mitral position (Ross II procedure) as an alternative surgical technique. We present a review of the literature, historical perspectives, indications, selection criteria, and surgical technique for the Ross II procedure. Our literature search identified 14 studies that reported results from the Ross II operation. Performed in 103 patients, the overall in-hospital mortality was 7 (6.7%), with a late mortality of 10 (9%). Although further research is needed, current evidence suggests the Ross II operation is a valuable alternative in low-risk young patients where valve durability and the complication rate from other procedures is unsatisfactory and anticoagulation not ideal.
Department of Robotic and Minimally Invasive Cardiothoracic Surgery, St. Mary's Hospital, London, United Kingdom. tathan5253@aol.com
Thanos
T
Athanasiou
Ashok
A
Cherian
Donald
D
Ross
D000293:Adolescent; D000328:Adult; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D017052:Hospital Mortality; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D018579:Patient Selection; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000401:mortality; D011300:Preoperative Care; D011664:Pulmonary Valve / Q000637:transplantation*; D012306:Risk; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D011093:Polyethylene Terephthalates