Should we still do the Ross operation in adults?
OBJECTIVE
To update the long-term results of the Ross procedure in adults and to establish the current role of this operation for the management of aortic valve disease.


RESULTS
Early outcomes continue to be excellent. Follow-up beyond 10 years, however, demonstrates continued deterioration of the autografts and need for reoperation in a substantial percentage of patients, particularly those in whom the root replacement technique was used.


CONCLUSIONS
Until the long-term results of alternatives to the aortic root technique for implantation (i.e., subcoronary) become available, and until the long-term results with other techniques, such as implantation of the autograft root within a synthetic vascular graft, are known, the Ross procedure should not be routinely performed in adult patients.
Division of Cardiovascular and Thoracic Surgery, Missouri Baptist Medical Center, BJC Health System, 3009 North Ballas Road, St Louis, MO 63131, USA. ntkouch@aol.com
Nicholas T
NT
Kouchoukos
D000328:Adult; D000367:Age Factors; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D012086:Reoperation; D014182:Transplantation, Autologous