Thorac Cardiovasc Surg 2010; 58 - V210
DOI: 10.1055/s-0029-1247047

What happens to patients in the second decade after the Ross operation? Results from the German-Dutch Ross registry

M Misfeld 1, EI Charitos 2, D Richardt 2, D Robinson 3, AJJC Borgers 4, W Hemmer 5, U Franke 6, J Boehm 5, J Rein 5, C Botha 7, R Lange 8, J Hörer 8, A Moritz 9, T Wahlers 10, M Breuer 11, K Ferrari-Kuehne 11, R Hetzer 12, M Hübler 12, A Gorski 13, G Ziemer 14, JJM Takkenberg 4, T Hanke 2, HH Sievers 2, U Stierle 2
  • 1Herzzentrum Leipzig, Klinik für Herzchirurgie, Leipzig, Germany
  • 2UKSH, Campus Lübeck, Klinik für Herz- und Thorakale Gefäßchirurgie, Lübeck, Germany
  • 3Department of Mathematics, Brighton, United Kingdom
  • 4Erasmus Medical Center, Rotterdam, Netherlands
  • 5Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Germany
  • 6Robert Bosch Krankenhaus, Klinik für Herz- und Gefäßchirurgie, Stuttgart, Germany
  • 7Herzzentrum Bodensee, Kreuzlingen, Switzerland
  • 8Deutsches Herzzentrum München, München, Germany
  • 9Universitätsklinikum Frankfurt, Klinik für Thorax-, Herz- und Gefäßchirurgie, Frankfurt/Main, Germany
  • 10Universitätsklinikum Köln, Klinik für Herz- und Thoraxchirurgie, Köln, Germany
  • 11Friedrich-Schiller University Jena, Klinik für Herz- und Thoraxchirurgie, Jena, Germany
  • 12Deutsches Herzzentrum Berlin, Berlin, Germany
  • 13Universität Würzburg, Klinik für Herz- und Thoraxchirurgie, Würzburg, Germany
  • 14Universität Tübingen, Klinik für Herz- und Gefäßchirurgie, Tübingen, Germany

Objectives: The Ross operation offers excellent hemodynamic and clinical outcome in a selected group of patients undergoing aortic valve replacement. To determine whether this outcome remains stable, follow-up data beyond 10 years are of great interest.

Methods: Out of 1620 Ross operations, a total number of 411 pts (mean age: 35.8±17.5 years, range: 0.02–70.5 years, 74% male) with a FU of at least 10 years (mean 11.1±3.5 years, up to 20.4 years) were identified. Underlying valve disease was aortic regurgitation in 134 pts, stenosis in 90 and combined lesion in 185 pts.

Results: Completeness of FU was 96%. In-hospital mortality was 2.2% (9/411). During the follow-up, 36 deaths were observed (25 cardiac, 11 non-cardiac). 85 Ross procedure-related reoperations were observed (autograft-explantation: 56, autograft reconstruction: 7, allograft explantation: 25, allograft reconstruction: 8). At last FU, 25.8% were in NYHA class I, 39.9% in NYHA II, 25.3% in NYHA III and 5.4% in NYHA IV (15 pts unknown). Long-term survival was: 94.8% at 10 years, 90.5% at 14 years in adults (>16 years of age) and 93.2% at 10 years and 93.2% at 14 years in children. A comparison with the survival probability of the general German population revealed no difference in the survival between Ross pts and the German population.

Conclusions: In this series of patients, long-term follow-up data beyond 10 years showed sustained clinical benefit with a low valve related reoperation and mortality rate. These results may add important information for choosing the surgical technique in a selective group of patients undergoing aortic valve surgery.