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DOI: 10.1055/s-0033-1354461
The Ross Procedure – A Viable Solution for Pediatric Aortic Valve Disease
Background: The Ross procedure is a cornerstone in the treatment of pediatric aortic valve disease. The major advantages are the favorable hemodynamic profile and the growth potential of the autograft. However, the widespread use of the procedure is still limited due to the technical challenge and adverse outcomes regarding the right ventricular outflow tract (RVOT). We present the long-term outcome in a single center regarding mortality and need for valvular reintervention.
Methods: All pediatric patients who received a Ross procedure as freestanding root replacement (modified Yacoub technique) at our institution between 1991 and 2011 were followed.
Results: A total of 70 patients (20 females) with an average age of 10 ± 5 years and a body mass index of 20 ± 4 kg/m2 underwent the Ross procedure. Twenty-six percent had an intervention prior to surgery and 37% had a previous surgical procedure. The median follow-up was 8.6 years. Early mortality was 1.4%, valve related mortality was 1.4%, and the overall mortality was 5.7%. Eight patients (11.4%) were reoperated with a time to reoperation of 8 ± 4 years. Two procedures had to be done at the autograft and six procedures at the RVOT. Furthermore, five catheter-based valve procedures were performed on the RVOT. Reoperations were more frequent in xenografts than in homografts.
Conclusion: The Ross procedure provides good early results and an excellent valve-related long-term survival. It represents, in our opinion, the preferred method of aortic valve replacement in children.