{Reference Type}: Journal Article
{Title}: Long-term outcome after the Ross procedure in 173 adults with up to 25 years of follow-up.
{Author}: Van Hoof L;Rooyackers B;Schuermans A;Duponselle J;Van De Bruaene A;De Meester P;Troost E;Meuris B;Budts W;Gewillig M;Flameng W;Daenen W;Meyns B;Verbrugghe P;Rega F;
{Journal}: Eur J Cardiothorac Surg
{Volume}: 66
{Issue}: 1
{Year}: 2024 Jul 1
{Factor}: 4.534
{DOI}: 10.1093/ejcts/ezae267
{Abstract}: <B>OBJECTIVE: </B>The potential risk of autograft dilatation and homograft stenosis after the Ross procedure mandates lifelong follow-up. This retrospective cohort study aimed to determine long-term outcome of the Ross procedure, investigating autograft and homograft failure patterns leading to reintervention.<BR><B>METHODS: </B>All adults who underwent the Ross procedure between 1991 and 2018 at the University Hospitals Leuven were included, with follow-up data collected retrospectively. Autograft implantation was performed using the full root replacement technique. The primary end-point was long-term survival. Secondary end-points were survival free from any reintervention, autograft or homograft reintervention-free survival, and evolution of autograft diameter, homograft gradient and aortic regurgitation grade over time.<BR><B>RESULTS: </B>A total of 173 adult patients (66% male) with a median age of 32 years (range 18-58 years) were included. External support at both the annulus and sinotubular junction was used in 38.7% (67/173). Median follow-up duration was 11.1 years (IQR, 6.4-15.9; 2065 patient-years) with 95% follow-up completeness. There was one (0.6%) perioperative death. Kaplan-Meier estimate for 15-year survival was 91.1% and Ross-related reintervention-free survival was 75.7% (autograft: 83.5%, homograft: 85%). Regression analyses demonstrated progressive neoaortic root dilatation (0.56 mm/year) and increase in homograft gradient (0.72 mmHg/year).<BR><B>CONCLUSIONS: </B>The Ross procedure has the potential to offer excellent long-term survival and reintervention-free survival. These long-term data further confirm that the Ross procedure is a suitable option in young adults with aortic valve disease which should be considered on an individual basis.