title: Single-centre experience of 101 paediatric and adult Ross procedures: mid-term results.
abstract: We aimed to determine outcomes for the Ross procedure in paediatric and adult patients, with particular emphasis on survival, complication and reintervention rates. A retrospective review of 101 patients who had the Ross procedure in a congenital cardiac surgical centre serving a population of approximately 2.5 million was performed. There were 69 adults and 32 children with a mean age of 24.8 ± 13.9 years. Indications for surgery were aortic stenosis (48), regurgitation (10), mixed disease (35) and complex left outflow tract obstruction (8). The mean follow-up duration was 4.7 ± 3.7 years. The mini-inclusion technique was used to incorporate the autograft, and in all cases, pulmonary homografts were placed in the right ventricular outflow tract. Sub-aortic resection was also performed in six and Ross-Konno operations in eight patients. There were no early deaths and there was one late death secondary to endocarditis. Freedom from reintervention was 92% at 5 years and 77% at 10 years. Children were significantly more likely to require reintervention (16%, 5 of 32 versus 4%, 3 of 69, P = 0.05). The Ross procedure carries low early and mid-term mortality, and reintervention rates appear acceptable. The Ross procedure should be considered a feasible alternative to prosthetic valves in patients who require aortic valve replacement.
authors.affiliation: Department of Paediatric Cardiology, Freeman Hospital, Newcastle-upon-Tyne, UK. angmcb@yahoo.co.uk
authors.forename: Angela
authors.initials: A
authors.lastname: McBrien
authors.forename: Milind
authors.initials: M
authors.lastname: Chaudhari
authors.forename: David S
authors.initials: DS
authors.lastname: Crossland
authors.forename: Helen
authors.initials: H
authors.lastname: Aspey
authors.forename: Alison
authors.initials: A
authors.lastname: Heads-Baister
authors.forename: Massimo
authors.initials: M
authors.lastname: Griselli
authors.forename: John
authors.initials: J
authors.lastname: O'Sullivan
authors.forename: Asif
authors.initials: A
authors.lastname: Hasan
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004739:England; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011664:Pulmonary Valve / Q000637:transplantation*; D019233:Retreatment; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult