title: Impact of Ross Operation on Outcome in Young Female Adult Patients Wanting to Have Children.
abstract: BACKGROUND
  The most appropriate valve substitute at aortic valve replacement (AVR) for young female adult patients wanting to have children is unclear.
  
  
  RESULTS
  Between 1992 and 2013, 12 consecutive female patients aged >18 (median, 22.5 years; range, 18-34 years) underwent Ross operation (Ross group). Between 1984 and 2013, 9 consecutive female patients aged >18 (median, 30 years; range, 22-39 years) underwent AVR with bioprosthesis (bioprosthesis group). There was 1 late mortality in the bioprosthesis group, due to prosthetic valve endocarditis (PVE). Freedom from reoperation for aortic valve at 15 years was 90.0% in the Ross group, and 57.1% in the bioprosthesis group (log-rank, P=0.098). One in the Ross group underwent reoperation for aortic regurgitation (AR), whereas 4 in the bioprosthesis group did so for aortic stenosis (AS) in 2, combined AS and AR in 1, and PVE in 1. Five patients in the Ross group and 3 in the bioprosthesis group had 7 and 4 uneventful pregnancies, respectively. AR progressed during the perinatal period in a total of 7 of 11 pregnancies. No AS was seen at discharge, after 5 years, or during pregnancy in the Ross group.
  
  
  CONCLUSIONS
  The long-term outcome of Ross operation for female patients wanting to have children is excellent. Although subclinical pulmonary autograft valve regurgitation during pregnancy was often observed, pulmonary autograft stenosis did not occur, therefore it would be an ideal option for patients wanting to have children.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Morimoto
authors.forename: Takaya
authors.initials: T
authors.lastname: Hoashi
authors.forename: Koji
authors.initials: K
authors.lastname: Kagisaki
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshimatsu
authors.forename: Isao
authors.initials: I
authors.lastname: Shiraishi
authors.forename: Hajime
authors.initials: H
authors.lastname: Ichikawa
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakatani
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Yagihara
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kitamura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujita
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies