The Pulmonary Autograft After the Ross Operation: Results of 25-Year Follow-Up in a Pediatric Cohort

BackgroundProgressive autograft dilation and need for later reoperation remain major concerns of the Ross procedure. The study investigates clinical outcome after operation, including a longitudinal analysis dimensions over 25 years.MethodsFrom November 1991 to April 2019, 137 patients underwent procedure at University Hospitals UCL (Université catholique de Louvain)-Brussels Ghent. Inclusion criteria were less than or equal 18 years age pulmonary implantation by root replacement. Outcome focused on survival, rate, size evolution through linear mixed-model analysis.ResultsA Ross-Konno operation was performed in 110 (80%) 27 (20%) median 10.4 (interquartile range [IQR], 4.7-14.3) 0.5 (IQR, 0.04-5.2) years, respectively. Overall 10-year 20-year survival 87% ± 3% 85% 3%, respectively, but 93% isolated patients. Right ventricular outflow tract–conduit exchange required 20.3%, whereas autograft-related 14 (10.7%) interval 9-16) aortic regurgitation (n = 2) 12). Autograft z-values increased significantly sinus sinotubular junction (STJ) compared with annulus (annulus 0.05 0.38/y, 0.14 0.25/y, STJ 0.17 0.34/y; P .015). z-value slope steeper vs (annulus: .029; sinus: < .001; STJ: .012), children having arch repair .113, .038; .029).ConclusionsThe offers requiring valve replacement an excellent perspective, acceptable risk within first years. Contrary annulus, is concern. Closer surveillance might be who reconstruction. Progressive From analysis. A .029).