PMID- 10660167
OWN - NLM
STAT- MEDLINE
DCOM- 20000229
LR  - 20041117
IS  - 1043-0679 (Print)
IS  - 1043-0679 (Linking)
VI  - 11
IP  - 4 Suppl 1
DP  - 1999 Oct
TI  - Critical analysis of the Ross procedure: do its problems justify wider 
      application?
PG  - 55-61
AB  - The Ross procedure has shown superior hemodynamic results in young patients with 
      aortic root pathology. Wider application of the procedure is restricted by its 
      technical complexity and potential associated problems. The mortality/morbidity 
      associated with 130 consecutive patients who have had the Ross procedure using 
      the root replacement implantation technique between October 29, 1990, and October 
      8, 1998 is summarized. New York Heart Association (NYHA) preoperatively was class 
      I, 23.5%; class II, 64.7%; and class III, 11.8%; mean age was 36 years (range 3 
      to 67 years). Men accounted for 73.8% and women 26.2% of the series. Preoperative 
      diagnosis was congenital, 80.7%; rheumatic, 5.3%; failed prosthesis, 7.0%; 
      degenerative, 2.6%; and endocarditis, 4.4% with preoperative aortic insufficiency 
      (AI) 7.9% 1+, 19.8% 2+, 29.7% 3+, and 42.6% 4+, respectively. At operation mean 
      cross-clamp time was 201 minutes (range 102 to 280 minutes). Patient follow-up 
      was 99.2% (1 patient lost to follow-up), and 94.4% were NYHA class I at follow-up 
      and 5.6% class II. Postoperative AI was 0 to 1 + in 93.6% and 2+ or greater in 
      6.4%. Mean time to patient follow-up was 436 days (range, 20 days to 2,878 days). 
      Thirty-day mortality rate was 1.5%; one patient died of mediastinal bleeding, and 
      one from complications of acute pancreatitis. There was no late mortality. Early 
      autograft explant occurred in one patient secondary to iatrogenic injury to the 
      pulmonary autograft at the time of harvesting, and one late explant occurred 
      secondary to proximal suture line dehiscence. Late autograft repair occurred in 
      one patient secondary to a false aneurysm along the proximal suture line; one 
      patient was reoperated for left main coronary stenosis relative to iatrogenic 
      injury at the time of the procedure. Right ventricular outflow tract replacement 
      has occurred in two patients. Postoperative morbidity and mortality for the Ross 
      procedure, as shown in this series, remains low and supports broader application 
      of the procedure.
FAU - Oury, J H
AU  - Oury JH
AD  - The International Heart Institute of Montana, Foundation, Missoula 59802, USA.
FAU - Mackey, S K
AU  - Mackey SK
FAU - Duran, C M
AU  - Duran CM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Semin Thorac Cardiovasc Surg
JT  - Seminars in thoracic and cardiovascular surgery
JID - 8917640
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aortic Valve/*surgery
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Diseases/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology/*etiology
MH  - Pulmonary Valve/*transplantation
MH  - Vascular Surgical Procedures/*adverse effects/*methods
EDAT- 2000/02/05 09:00
MHDA- 2000/03/04 09:00
CRDT- 2000/02/05 09:00
PHST- 2000/02/05 09:00 [pubmed]
PHST- 2000/03/04 09:00 [medline]
PHST- 2000/02/05 09:00 [entrez]
AID - S1043067999000532 [pii]
PST - ppublish
SO  - Semin Thorac Cardiovasc Surg. 1999 Oct;11(4 Suppl 1):55-61.