The Ross procedure in adults: Intermediate-term results

David A. Fullerton, James W. Fredericksen, R. Sudhir Sundaresan, Keith A. Horvath, John H Calhoon, Davis C. Drinkwater, John D. Oswalt

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background. The durability of the Ross procedure may be optimized by appropriate geometric matching of the aortic and pulmonary artery roots. We employed a surgical strategy to standardize the operation in order to avoid more readily a geometric mismatch. Methods. The Ross procedure was performed as a root replacement. Without regard for patient body surface area, the aortic annulus was plicated to 23 mm and externally buttressed with felt. Geometric mismatch of the distal autograft anastomosis was avoided by liberal use of a synthetic interposition graft, and the anastomosis was also externally buttressed with felt. An over-sized pulmonary homograft (27 to 28 mm) was routinely used to reconstruct the right ventricular outflow tract. Results. Forty-four consecutive patients (27 men and 17 women; mean age, 49 ± 9 years) were operated on between January 1997 and March 2002. Mean follow-up was 38 ± 5 months. Twenty-nine patients had aortic stenosis and 15 had aortic regurgitation. Aortic annular plication was done in 41 (93%) and an aortic interposition was used in 14 (32%). There were three hospital deaths, with no subsequent deaths. Only 1 patient required reoperation 2.5 years postoperatively from recurrent endocarditis. No patient has more that "trivial" autograft insufficiency, and the mean autograft gradient was 7 ± 3 mm Hg. No patient has significant pulmonary homograft stenosis. Conclusions. Geometric matching of the aortic and pulmonary roots may be readily accomplished using a standardized approach to the Ross procedure. In turn, this may optimize the durability of the operation.

Original languageEnglish (US)
Pages (from-to)471-477
Number of pages7
JournalAnnals of Thoracic Surgery
Volume76
Issue number2
DOIs
StatePublished - Aug 1 2003
Externally publishedYes

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Autografts
Allografts
Lung
Pulmonary Valve Stenosis
Aortic Valve Insufficiency
Body Surface Area
Aortic Valve Stenosis
Endocarditis
Reoperation
Pulmonary Artery
Transplants

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Fullerton, D. A., Fredericksen, J. W., Sundaresan, R. S., Horvath, K. A., Calhoon, J. H., Drinkwater, D. C., & Oswalt, J. D. (2003). The Ross procedure in adults: Intermediate-term results. Annals of Thoracic Surgery, 76(2), 471-477. https://doi.org/10.1016/S0003-4975(03)00532-0

The Ross procedure in adults : Intermediate-term results. / Fullerton, David A.; Fredericksen, James W.; Sundaresan, R. Sudhir; Horvath, Keith A.; Calhoon, John H; Drinkwater, Davis C.; Oswalt, John D.

In: Annals of Thoracic Surgery, Vol. 76, No. 2, 01.08.2003, p. 471-477.

Research output: Contribution to journalArticle

Fullerton, DA, Fredericksen, JW, Sundaresan, RS, Horvath, KA, Calhoon, JH, Drinkwater, DC & Oswalt, JD 2003, 'The Ross procedure in adults: Intermediate-term results', Annals of Thoracic Surgery, vol. 76, no. 2, pp. 471-477. https://doi.org/10.1016/S0003-4975(03)00532-0
Fullerton DA, Fredericksen JW, Sundaresan RS, Horvath KA, Calhoon JH, Drinkwater DC et al. The Ross procedure in adults: Intermediate-term results. Annals of Thoracic Surgery. 2003 Aug 1;76(2):471-477. https://doi.org/10.1016/S0003-4975(03)00532-0
Fullerton, David A. ; Fredericksen, James W. ; Sundaresan, R. Sudhir ; Horvath, Keith A. ; Calhoon, John H ; Drinkwater, Davis C. ; Oswalt, John D. / The Ross procedure in adults : Intermediate-term results. In: Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 2. pp. 471-477.
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