The Reinforced Full-Root Technique for the Ross Operation: A Single-Center Experience in 832 Patients

Background: The aim of the study was to report on the surgical techniques of the Ross operation and to evaluate long-term postoperative outcomes using the reinforced full-root technique.

Method: Between 1995 and 2020, a total of 832 patients (mean age, 43.4 ± 13.7 years; 617 males) were treated with a Ross operation using the reinforced full-root technique. Patients were prospectively monitored clinically and echocardiographically. Follow-up was 9,046 patients-years and was 92% complete. Mean follow-up was 10.9 ± 6.9 years (range, 0–24.9 years).

Results: Survival at 20 years was 92% (95% CI: 09–94%). Freedom from autograft or right-ventricle to pulmonary artery connection reoperation at 20 years was 79% (95% CI: 74–85%). Eighty-nine pulmonary autograft reoperations had to be performed in eighty patients. Autograft salvage could be performed in forty-six patients (58%). Fifty-seven patients required 63 reoperations on the right ventricle to pulmonary artery connection. Major cerebral bleeding occurred in one patient and neurological events in seventeen patients, respectively.

Conclusion: The Ross operation with the reinforced full-root technique demonstrated excellent survival in young and middle-aged patients over a follow-up interval of up to 25 years. Pulmonary autograft and cryopreserved homograft reintervention/reoperation rate were low in this patient subset. Therefore, the Ross operation with the reinforced full-root technique represents an enduring and valid treatment option in young and middle-aged patients suffering from aortic valve disease.

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Artikel online veröffentlicht:
28. Januar 2023