MID-TERM RESULTS OF THE ROSS OPERATION

Background – The Ross operation, originally introduced as a scalloped subcoronary implant with an 80% survival and 85% freedom from reoperation, has recently been modified to a root replacement which is now the most commonly utilized implant technique. A review of our experience in assessing the mid-term results with the Ross operation is presented. Methods – The records of 60 patients who had a Ross operation at the Imam Khomeini Hospital of Tehran University of Medical Sciences (June 2001 to October 2002) were reviewed to assess the operative technique and patient-related factors on survival, autograft valve function, homograft valve function, valve-related complications, and need for reoperation. Results – Two patients were expired (one case in the operating room and the other one in hospital, 20 days after the operation with neurological disorder). The 2-year actuarial survival rate was 96.6%. At 2 years, 53 (91.3%) surviving patients were in New York Heart Association (NYHA) functional class I and 5 (8.7%) were in NYHA functional class II. No significant aortic valve gradients were noted, and no pulmonary insufficiency, in all cases, was found. At 2 years, freedom from significant aortic regurgitation (grade 2 or more) was 98.3%. Freedom from significant pulmonary homograft stenosis (defined as a pulmonary gradient > 20 mmHg) was 100% at 2 years. Conclusion – The pulmonary autograft gives excellent mid-term results with low mortality and no morbidity. It completely relieves the abnormal loading conditions of the left ventricle, resulting in a complete recovery of left ventricular function in most patients.