Late Results of the Ross Procedure

This prospective single-surgeon series reports 30-year outcomes after the Ross procedure in 212 consecutive patients operated on between 1990 and 2004. The median age was 34 years; 108 patients underwent freestanding aortic root replacement, and 104 underwent root inclusion. Median follow-up was 26.6 years. Survival at 10, 20, and 30 years was 97.6 percent, 91.3 percent, and 79.4 percent, respectively—9.1 percentage points lower than the matched Canadian population. Ross-related reintervention occurred in 47 patients, totaling 64 surgical and 12 percutaneous procedures. At 30 years, the rates of autograft reoperation were 19.1 percent, autograft dysfunction was 38.0 percent, and homograft dysfunction was 64.3 percent. The authors conclude that the Ross procedure is valuable in young adults but does not restore normal lifespan.