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The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 705-711, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
O Matsuki, Y Okita, RS Almeida, JP McGoldrick, TL Hooper, A Robles and DN Ross
Aortic valve replacement with a pulmonary autograft was performed on 241
patients between June 1967 and October 1986 at National Heart Hospital,
Guy's Hospital, Middlesex Hospital, Harley Street Clinic, and Italian
Hospital in London by one of the authors (D.N.R.). The longest follow-up is
18 years 7 months, and the cumulative total follow-up is 1130 patient-years
(pt-yr). The overall 30-day mortality rate is 6.6% (16 patients), with no
deaths after 1976, and the late mortality rate is 1.7%/pt-yr (19 patients).
The actuarial survival rate is 57.3% +/- 9.6% at 19 years. No
anticoagulation has been used and there have been no thromboembolic
episodes. The incidence of bacterial endocarditis is 1.2%/pt-yr (14
patients), and its actuarial event-free rate is 74.2% +/- 8.1% at 19 years.
Reoperation because of failure of the pulmonary autograft was performed on
36 patients, 27 of whom needed valve replacement. The incidence of
pulmonary autograft replacement is 2.5%/pt-yr, and its actuarial event-free
rate is 48.5% +/- 13.7% at 19 years. For reconstruction of the right
ventricular outflow tract, 186 aortic homografts, 26 pulmonary homografts,
16 autologous fascia lata valved conduits, 7 autologous pericardial
conduits with or without a valve, and 6 xenograft valved Dacron conduits
were used. Thirty-one patients were reoperated on, mostly because of
degeneration of this material. Pulmonary rather than aortic homografts are
now favored for reconstruction of the right ventricular outflow tract
Because of its satisfactory long-term result without the need for
anticoagulation, as well as its safety as an established surgical
procedure, this operation can be recommended to a wider range of patients.
ARTICLES
Two decades' experience with aortic valve replacement with pulmonary autograft
National Heart Hospital, London, England.
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S. G Raja and M. Pozzi Growth of Pulmonary Autograft After Ross Operation in Pediatric Patients Asian Cardiovasc Thorac Ann, December 1, 2004; 12(4): 285 - 290. [Abstract] [Full Text] [PDF]
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D. R. Koolbergen, M. G. Hazekamp, E. de Heer, F. van Hoorn, H. A. Huysmans, J. A. Bruijn, and R. A.E. Dion Structural degeneration of pulmonary homografts used as aortic valve substitute underlines early graft failure Eur. J. Cardiothorac. Surg., November 1, 2002; 22(5): 802 - 807. [Abstract] [Full Text] [PDF]
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 F. X. Schmid, A. Keyser, C. Wiesenack, S. Holmer, and D. E. Birnbaum Stentless xenografts and homografts for right ventricular outflow tract reconstruction during the ross operation Ann. Thorac. Surg., September 1, 2002; 74(3): 684 - 688. [Abstract] [Full Text] [PDF]
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J.-M. Grinda, C. Latremouille, A. J. Berrebi, R. Zegdi, S. Chauvaud, A. F. Carpentier, J.-N. Fabiani, and A. Deloche Aortic cusp extension valvuloplasty for rheumatic aortic valve disease: midterm results Ann. Thorac. Surg., August 1, 2002; 74(2): 438 - 443. [Abstract] [Full Text] [PDF]
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J.-M. Grinda, C. Latremouille, N. D'Attellis, A. Berrebi, S. Chauvaud, A. Carpentier, J.-N. Fabiani, and A. Deloche Triple valve repair for young rheumatic patients Eur. J. Cardiothorac. Surg., March 1, 2002; 21(3): 447 - 452. [Abstract] [Full Text] [PDF]
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Z. Al-Halees, F. Pieters, F. Qadoura, M. Shahid, M. Al-Amri, and F. Al-Fadley The Ross procedure is the procedure of choice for congenital aortic valve disease J. Thorac. Cardiovasc. Surg., March 1, 2002; 123(3): 437 - 442. [Abstract] [Full Text] [PDF]
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E. A. Bacha, G. M. Satou, A. M. Moran, D. Zurakowski, G. R. Marx, J. F. Keane, and R. A. Jonas Valve-sparing operation for balloon-induced aortic regurgitation in congenital aortic stenosis J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 162 - 168. [Abstract] [Full Text] [PDF]
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C. Schmidtke, J. F. M. Bechtel, A. Noetzold, and H.-H. Sievers Up to seven years of experience with the Ross procedure in patients >60 years of age J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1173 - 1177. [Abstract] [Full Text] [PDF]
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Z. L. Nagy, J. Fisher, P. G. Walker, and K. G. Watterson The in vitro hydrodynamic characteristics of the porcine pulmonary valve and root with regard to the Ross procedure J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 284 - 289. [Abstract] [Full Text] [PDF]
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C. J. Knott-Craig, R. C. Elkins, K. Santangelo, C. McCue, and M. M. Lane Aortic valve replacement: comparison of late survival between autografts and homografts Ann. Thorac. Surg., May 1, 2000; 69(5): 1327 - 1331. [Abstract] [Full Text] [PDF]
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C. Alexiou, A. McDonald, S. M. Langley, M. J.R. Dalrymple-Hay, M. P. Haw, and J. L. Monro Aortic valve replacement in children: are mechanical prostheses a good option? Eur. J. Cardiothorac. Surg., February 1, 2000; 17(2): 125 - 133. [Abstract] [Full Text] [PDF]
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B. S. Marino, G. Wernovsky, J. Rychik, J. R. Bockoven, R. I. Godinez, and T. L. Spray Early Results of the Ross Procedure in Simple and Complex Left Heart Disease Circulation, November 9, 1999; 100(90002): II-162 - 166. [Abstract] [Full Text] [PDF]
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K. M. Dossche, A. B. de la Riviere, W. J. Morshuis, M. A.A.M. Schepens, S. M. Ernst, and J. J. van den Brand Aortic root replacement with the pulmonary autograft: an invariably competent aortic valve? Ann. Thorac. Surg., October 1, 1999; 68(4): 1302 - 1307. [Abstract] [Full Text] [PDF]
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Z. L. Nagy, J. Fisher, P. G. Walker, and K. G. Watterson The influence of size mismatch on the hemodynamic performance of the pulmonary autograft in vitro Eur. J. Cardiothorac. Surg., March 1, 1999; 15(3): 294 - 301. [Abstract] [Full Text] [PDF]
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P. Stelzer, S. Weinrauch, and R. F. Tranbaugh Ten years of experience with the modified Ross procedure J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1091 - 1095. [Abstract] [Full Text] [PDF]
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F. C. Spencer The Development of Valvular Heart Surgery Over the Past 50 Years (1947-1997): Personal Recollections Ann. Thorac. Surg., November 1, 1997; 64(5): 1549 - 1554. [Abstract] [Full Text]
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J. C. Chambers, J. Somerville, S. Stone, and D. N. Ross Pulmonary Autograft Procedure for Aortic Valve Disease : Long-term Results of the Pioneer Series Circulation, October 7, 1997; 96(7): 2206 - 2214. [Abstract] [Full Text]
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L. A Durham III, S. E. desJardins, R. S. Mosca, and E. L. Bove Ross Procedure With Aortic Root Tailoring for Aortic Valve Replacement in the Pediatric Population Ann. Thorac. Surg., August 1, 1997; 64(2): 482 - 486. [Abstract] [Full Text]
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R. B. Hokken, A. J. J. C. Bogers, M. A. Taams, M. B. Schiks-Berghourt, L. A. van Herwerden, J. R. T. C. Roelandt, and E. Bos DOES THE PULMONARY AUTOGRAFT IN THE AORTIC POSITION IN ADULTS INCREASE IN DIAMETER? AN ECHOCARDIOGRAPHIC STUDY J. Thorac. Cardiovasc. Surg., April 1, 1997; 113(4): 667 - 674. [Abstract] [Full Text]
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R. B. Hokken, M. M. Bartelings, A. J. J. C. Bogers, and A. C. Gittenberger-de Groot MORPHOLOGY OF THE PULMONARY AND AORTIC ROOTS WITH REGARD TO THE PULMONARY AUTOGRAFT PROCEDURE J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 453 - 461. [Abstract] [Full Text]
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S. Y. DeLeon, J. A. Quinones, R. H. Miles, J. Hofstra, T. J. Bell, E. A. Fisher, and R. Pifarre Use of the Native Aortic Valve as the Pulmonary Valve in the Ross Procedure Ann. Thorac. Surg., April 1, 1995; 59(4): 1007 - 1010. [Abstract] [Full Text]
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 R. C. Elkins Pulmonary Autograft -- The Optimal Substitute for the Aortic Valve? N. Engl. J. Med., January 6, 1994; 330(1): 59 - 60. [Full Text]
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