title: Results and Quality of Life after Minimally Invasive Ross Procedure.
abstract: OBJECTIVE
  Based on superior long-term results, an increasing interest in the Ross procedure for young adult patients can be observed. After the first publication of this challenging procedure through a minimally invasive access, this operation has become an alternative to conventional sternotomy at the authors' department. This analysis compares the results and quality of life of the conventional and the minimally invasive Ross procedures.
  
  
  METHODS
  By April 2013, a total of 136 patients had undergone the Ross procedure at the authors' institution. Preoperative parameters did not differ between the conventional group (C-group; n = 58; mean age 49 years) and the minimally invasive group (M-group; n = 78; mean age 50 years). Only the aortic cross-clamp time was longer for the M-group (151 versus 140 min).
  
  
  RESULTS
  One C-group patient died on the day of operation. Consecutively, survival was 99% for the follow up period of 1,093 ± 601 days. Valve-related reoperations were necessary for four patients. One C-group patient developed a distal pulmonary stenosis due to fibrotic scar tissue. Two M-group patients showed fistulas after early endocarditis, but the native valves could be preserved in these cases. One C-group patient with recurrent severe aortic regurgitation showed holes in two of three cusps. The SF-36 questionnaire detected better physical parameters (physical function, physical role function) for patients after minimally invasive access.
  
  
  CONCLUSIONS
  The minimally invasive Ross procedure allows the same excellent clinical outcome as the conventional technique. However, the physical quality of life is better with the minimally invasive procedure, in addition to an improved cosmetic result.
authors.forename: Ulrich F W
authors.initials: UF
authors.lastname: Franke
authors.forename: Adrian
authors.initials: A
authors.lastname: Ursulescu
authors.forename: Nora
authors.initials: N
authors.lastname: Göbel
authors.forename: Ragi
authors.initials: R
authors.lastname: Nagib
authors.forename: Matthias
authors.initials: M
authors.lastname: Hansen
authors.forename: Rashmi
authors.initials: R
authors.lastname: Yadav
authors.forename: Hardy
authors.initials: H
authors.lastname: Baumbach
authors.forename: Marc
authors.initials: M
authors.lastname: Albert
mesh_terms: D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012086:Reoperation; D056346:Sternotomy / Q000379:methods*; D055815:Young Adult