Intermediate-term results of the Ross procedure in neonates and infants.
BACKGROUND
Although good intermediate-term results for the Ross procedure in adults and older children have been reported, only short-term outcomes of this procedure in neonates and infants have been published. The objective of this study was to review our intermediate-term results of the Ross procedure for neonates and infants.


METHODS
The records of all 31 neonates and infants undergoing a Ross procedure between March 1993 and June 2008 were reviewed. Major study outcomes included patient survival, autograft function, and need for reoperation.


RESULTS
The median age at the time of operation was 18 days, and median weight was 3.95 kg. Fifteen patients had aortic stenosis with or without insufficiency, 2 patients had isolated severe aortic insufficiency, and 14 patients had aortic stenosis with other left-side heart lesions, such as arch obstruction or mitral valve disease. Twenty-five patients required aortic annular enlargement (Ross-Konno procedure), and 14 required concomitant arch or mitral valve surgery. There were 5 early and 2 late deaths at a median follow-up of 6.0 years (range, 1.1 to 15.4 years). All early deaths were in patients requiring concomitant arch or mitral valve repair. Actuarial survival rate was 76.7% at 5, 10, and 15 years. There were 19 reinterventions, including 2 procedures on the autograft. Overall freedom from reoperation was 59.1% at 5 years and 50.6% at 10 years. Freedom from autograft reoperation was 95.2% at 5 and 10 years and 63.5% at 15 years.


CONCLUSIONS
The Ross procedure for neonates and infants has good intermediate-term results with low mortality and acceptable rates of reintervention. The patients requiring concomitant arch or mitral valve surgery have higher initial operative risks although conditional survival remains good.
Shinkawa
Takeshi
T
Division of Pediatric Cardiovascular Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Bove
Edward L
EL
Hirsch
Jennifer C
JC
Devaney
Eric J
EJ
Ohye
Richard G
RG
D001021:Aortic Valve; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome