Abstract 3713: Autograft Regurgitation Over Time After Ross Procedure-Experiences from the German Ross Registry
Objectives: In the time course after the ROSS procedure autograft regurgitation is a potential hazard of utmost clinical impact. We reviewed our experience with the ROSS procedure to identify development of autograft regurgitation over time after two different techniques of autograft implantation.
Methods: Between 1990 and 2006 914 patients (716 m, 198 f; mean age 40.9 ± 15.5y) underwent the ROSS procedure with 2 different implantation techniques (subcoronary=SC, n=460; root replacement=RR, n=432). Clinical follow-up was accomplished annually (mean 4.2 ± 3.0 y, range 0.1 - 16 y; 3412.5 patient-years, 4 pts lost to follow-up). Echocardiographic examinations were performed pre-operatively with a close follow-up during the first post-operative year and thereafter annually in 718 pts (complete data sets). Results: Six early and 25 late deaths were observed (cardiac origin in 20 pts). Reoperation on the pulmonary autograft was required in 22 pts.
Conclusion: The present ROSS series from the German Ross Registry showed favorable clinical and hemodynamic results for both implantation techniques in the mid term run. New onset of postoperative AR is minor for both implantation techniques. A gradual, constant increase of aortic valve incompetence over time cannot be found in either group. Including all AR grades into an inter-group comparison, AR is significant lesser apparent in the SC group at all follow-up time intervals. Moderate and moderate-severe AR (grade II and III) was observed equally distributed between the implantation techniques. The present mid-term experience did not proof the hypothesis of a steady increase of autograft regurgitation over time.