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DOI: 10.1055/s-0040-1705367
Long-Term Outcomes for Patients Undergoing the Ross Procedure in 10 European Heart Centers: An Update from the Ross Registry
Publication History
Publication Date:
13 February 2020 (online)
Objectives: The aim of this multicenter study was to investigate long-term outcomes after the Ross procedure in the adult and pediatric patient population.
Methods: The Ross Registry includes data from 10 Heart Centers throughout Europe that have treated patients with the Ross Procedure. Long-term survival and reoperation rates were investigated in pediatric and adult patients separately.
Results: A total of 2,540 patients, of which 2,316 were adult and 224 pediatric patients were identified. The median follow-up time was 10.1 years (range: 0–27.4 years). All-cause 30-day mortality was 1.3%. Estimated 24-year survival rates were 74.9% in adults and 88.3% in pediatric patients. Ross-related reoperation rates were 9.3% in adults and 23.6% in pediatric patients. Autograft reintervention was performed in 6.3% in adults and 6.3% in pediatric patients while homograft reintervention was performed in 6.2% in adults and 36.2% in pediatric patients. Valvular thromboembolism occurred in 0.5% of adults and 1.1% of children while peripheral thromboembolism occurred in 0.7% of adults and 0.7% of children.
Conclusion: The Ross procedure provides excellent long-term survival rates in both, the adult and pediatric patient population, even in the third decade after the initial operation. This registry data emphasize that the Ross procedure should be used more often for treatment of aortic valve disease. The rate of thromboembolic complications during follow-up was extremely low despite the absence of anticoagulation. However, homograft failure in pediatric patients is still the Achilles’ heel of the procedure.