TY - JOUR T1 - Long-term assessment of the Ross procedure in adults: Clinical and echocardiographic follow-up at 20 years JO - Revista Portuguesa de Cardiologia T2 - AU - Guerreiro,Sara AU - Madeira,Márcio AU - Ribeiras,Regina AU - Queiroz e Melo,João AU - Canada,Manuel AU - Horta,Eduarda AU - Reis,Carla AU - Neves,José Pedro AU - Mendes,Miguel SN - 08702551 M3 - 10.1016/j.repc.2018.06.014 DO - 10.1016/j.repc.2018.06.014 UR - https://www.revportcardiol.org/pt-long-term-assessment-ross-procedure-in-articulo-S0870255118300313 AB - IntroductionThe Ross procedure is an alternative to standard aortic valve (AV) replacement in young and middle-aged patients. However, durability and incidence of reoperation remain a concern for most cardiac surgeons. Our aim was to assess very long-term clinical and echocardiographic outcomes of the Ross procedure. MethodsWe conducted a single-center retrospective analysis of 56 consecutive adult patients who underwent the Ross procedure. Mean age at surgery was 44±12 years (range, 16-65 years) and 55% were male. Clinical endpoints included overall mortality and the need for valve reoperation due to graft failure. The echocardiographic endpoint was the presence of any graft deterioration. Median clinical follow-up was 20 years (1120 patient/years). ResultsIndications for surgery were dominant aortic stenosis in 50% and isolated aortic regurgitation in 21%. Concomitant mitral valve repair was performed in 21% and a subcoronary technique was most commonly used (86%). Overall long-term survival was 91%, 80% and 77% at 15, 20 and 24 years, respectively. The survival rate was similar to the age- and gender-matched general population (p=0.44). During the follow-up period, freedom from graft reoperation was 80%. Eleven patients (31%) developed moderate AV regurgitation, three (8.6%) developed moderate pulmonary regurgitation and one (2.9%) presented moderate pulmonary stenosis. ConclusionThe Ross procedure, mostly using a subcoronary approach, proved to have good clinical and hemodynamic results, with low reoperation rates in long-term follow-up. Moderate autograft regurgitation was a frequent finding but had no significant clinical impact. ER -