Survival and freedom from reoperation after the Ross procedure in a Russian adult population: A single-center experience

Bashir Tsaroev; Igor Chernov; Soslan Enginoev; Muslim Mustaev

doi:10.1016/j.xjon.2022.04.026

Survival and freedom from reoperation after the Ross procedure in a Russian adult population: A single-center experience

JTCVS Open. 2022 Apr 21:10:140-147. doi: 10.1016/j.xjon.2022.04.026. eCollection 2022 Jun.

Authors

Bashir Tsaroev^{1

2}, Igor Chernov¹, Soslan Enginoev^{1

3}, Muslim Mustaev⁴

Affiliations

¹ Federal State Budgetary Institution "Federal Center for Cardiovascular Surgery" of the Ministry of Health of the Russian Federation, Astrakhan, Astrakhan Region, Russia.
² Department of Vascular Surgery, Alexandro-Mariinsky Regional Clinical Hospital, Astrakhan, Astrakhan Region, Russia.
³ Department of Cardiovascular Surgery, Astrakhan State Medical University, Astrakhan, Astrakhan Region, Russia.
⁴ Department of Adult Cardiac Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

Abstract

Objectives: To evaluate our 12-year experience with the Ross procedure in adults.

Methods: A retrospective analysis of 215 cases of the Ross procedure was performed. The mean age of the patients was 36 ± 11.1 years, and the male to female ratio was 75% to 25%, respectively. The pulmonary autograft was placed into the aortic position using the full-root replacement technique and its modified versions. The right ventricular outflow tract was reconstructed using a pulmonary homograft in all cases.

Results: The 30-day mortality after the operation was 0.9% (2 patients). The median duration of follow-up was 6.1 years (interquartile range, 6.5 years) and was complete in 86% of cases. The survival at 12 years was 94.7% and was comparable with the survival rate of the general population matched for age and sex. At the end of the follow-up, freedom from reoperation due to pulmonary autograft and homograft dysfunction was 89.1% and 99%, respectively.

Conclusions: In our series, the Ross procedure resulted in low early mortality and excellent survival in adults. The long-term survival was not statistically different from the survival of the general population. The pulmonary homograft offered an excellent durability and freedom from reoperation.

Keywords: AV, aortic valve; AVR, aortic valve replacement; CI, confidence interval; IQR, interquartile range; RVOT, right ventricular outflow tract; Ross procedure; aortic valve replacement; pulmonary autograft.