Highlights of a ten-year experience with the Ross procedure

Oswalt, J. D.; Dewan, Stephen J.; Mueller, Michael C; Nelson, Suzi

doi:10.1016/s0003-4975(01)02497-3

Cited by 34 publications

(15 citation statements)

References 8 publications

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“…Criticism levelled against its use in such acutely ill high-risk patients includes increased bleeding and a propensity for myocardial dysfunction. Notwithstanding, excellent results with very low re-infection rates 17,18 have been achieved. Our experience is limited to two cases of endocarditis, and only one in the fl orid acute phase.…”

Section: Discussionmentioning

confidence: 95%

Early and Midterm Results with the Ross Procedure: A Study of the First 31 Cases

Matalanis

Durairaj

Shah

et al. 2004

Asian Cardiovasc Thorac Ann

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Between 1994 and 2002, 31 patients underwent the Ross procedure by a single surgeon. The mean age was 42 years (24-61), 87% were male and 61% were in New York Heart Association (NYHA) class III-IV. Pure aortic stenosis (AS) was present in 32% of patients, pure aortic regurgitation (AR) in 22% and mixed disease in the rest. The aortic valve was bicuspid in 93.5% of the patients. Autograft implantation was by full root replacement in all cases. Concomitant cardiac surgical procedures were carried out in 10/31 (32%). All patients had at least annual clinical and echocardiographic follow-ups. There was one early death (3%). Overall patient survival was 92.7% at 1 year and 86.1% at 5 years. Twenty-eight (96.55%) were in NYHA class I. Echocardiographic follow-up revealed none to trivial AR in 24/29 (82.75%) and mild AR in 4/29 (13.7%). There was no autograft re-operation before 5 years. The mean gradient across the autograft was low (< 4 mm Hg). There were no incidences of endocarditis or thromboembolism. None of the patients required anticoagulation. Our early experience with the Ross procedure has shown good results in relation to early and midterm morbidity, mortality, autograft, and homograft function.

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Section: Discussionmentioning

confidence: 95%

Early and Midterm Results with the Ross Procedure: A Study of the First 31 Cases

Matalanis

Durairaj

Shah

et al. 2004

Asian Cardiovasc Thorac Ann

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“…One certainly wonders, from our results, especially recognizing the relatively flat curve for thromboembolism and bleeding in Figure 2, whether the putative advantages of the Ross or valve-sparing procedures are great enough to forfeit the known durability of traditional composite graft replacement. One must also bear in mind that even the most recent reports of experience with the alternate procedures do not exceed midterm followup, with precious few patients beyond the five-year point [13][14][15][16][17][18]. Our intent is not to detract in any way from the Ross or valve-sparing procedures, which have great merits.…”

Section: Discussionmentioning

confidence: 98%

Midterm thromboembolic and bleeding complications are minimal after composite graft replacement of the aortic root

et al. 2011

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The rationale for the Ross procedure and for valve-sparing aortic root procedures is predicated on the presumption that traditional composite graft replacement of the aorta and aortic valve will be complicated by late thromboembolism and by warfarin-related bleeding. We evaluated this presumption by determining late followup after composite graft replacement of the ascending aorta and aortic valve. One hundred six consecutive patients (21 female, 85 male) underwent composite graft replacement between January 1995 and November 2004. Mean age was 54.5 years. Indication for surgery was chronic aneurysm in 93 patients and acute type A dissection in 13. St. Jude mechanical valve conduit was used in 95 (89.6%) patients (mean size ¼ 23 mm, range-19-31 mm), whereas 11 patients (10.4%) received a biological conduit (mean size-23 mm, range-19-27 mm). Warfarin goal for the St. Jude group was INR 1.8-2.2. Hospital mortality was 5.6% (6/106), including stroke 2.8% (3/106) and bleeding 1.8% (2/106). In-hospital morbidity was 12.2% (13/106). With a postoperative followup ranging from 1 to 114 months (mean-44.4), late causes of death were stroke in two patients (2%). Kaplan-Meier curves show five-year postdischarge survival at 97.3% and eightyear survival at 91.2%. Event-free survival was 89.3% at five years followup and 76.2 at eight years.Thromboembolism and bleeding complications were minimal in midterm followup after composite graft replacement. This information renders composite graft replacement relatively more attractive versus the surgical alternatives than previously appreciated.

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“…Excellent long term results have been reported and theoretically the pulmonary autograft may be more resistant to infection. [130] …”

Section: Aortic Root Replacement For Infected Endocarditismentioning

confidence: 99%

Surgical Management of the Aortic Root

Goslin¹,

Hooker²

2012

Current Concepts in General Thoracic Surgery

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Highlights of a ten-year experience with the Ross procedure

Cited by 34 publications

References 8 publications

Early and Midterm Results with the Ross Procedure: A Study of the First 31 Cases

Early and Midterm Results with the Ross Procedure: A Study of the First 31 Cases

Midterm thromboembolic and bleeding complications are minimal after composite graft replacement of the aortic root

Surgical Management of the Aortic Root

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