Long-term outcomes with the pulmonary autograft inclusion technique in adults with bicuspid aortic valves undergoing the Ross procedure

Commentary: Wrapping the Ross could prevent its loss!

“…We commend the authors for their outcomes comparing the pulmonary autograft inclusion technique (wrapped using a straight vascular conduit) and the unsupported autograft root replacement technique (unwrapped) in BAV patients. 5 Ten-year survival was excellent in both groups; however, autograft valve failure was higher in the unwrapped group compared with the wrapped group (35.2% vs 5.2%). The cumulative incidence of autograft reintervention at 10 years was significantly higher in the unwrapped group (26.4% vs 4%), and no aortic root intervention was needed in the wrapped group, as opposed to 16 out of 25 (64%) patients requiring aortic root replacement in the unwrapped group.…”

Commentary: Bespoke Ross procedure: Best fit for patients with aortic regurgitation?

“…7 Instead of abandoning this technically challenging but the ideal option in young and adult patients with AR, a few centers of excellence have attempted to refine their techniques to prevent annular dilatation and postoperative AR and to lessen the need for pulmonary autograft reintervention. 9,10,[12][13][14][15] In this issue of JTCVS Techniques, Mazine and El-Hamamsy 15 present an excellent and comprehensive review. The highlights include a detailed description of their own modified technique: full root replacement with extraaortic annuloplasty and interposition graft, plus technical refinements such as autologous inclusion technique and Dacron inclusion technique, which minimize late AR and annular dilatation in younger patients with AR.…”

“…The highlights include a detailed description of their own modified technique: full root replacement with extraaortic annuloplasty and interposition graft, plus technical refinements such as autologous inclusion technique and Dacron inclusion technique, which minimize late AR and annular dilatation in younger patients with AR. 8,9,[12][13][14][15] Since it was first described by Donald Ross 5 decades ago, 16 the Ross procedure has been refined and it is now possible to minimize the risk of late AR and annular dilation with superior hemodynamics and long-term survival compared with biological and mechanical aortic valves in younger patients. 2,17 Full root replacement with either autologous/Dacron inclusion technique provides 97% to 100% survival at 10 years after surgery.…”

Long-term outcomes of the Ross procedure in adults

“…Despite a dearth of enthusiasm in these guidelines, a limited number of surgeons have performed the Ross procedure in a substantial number of adults in the United States (18,19). At our center, the senior author has been performing the Ross procedure in adult patients for twentyfive-years (3).…”