Ross procedure still linked to ‘excellent’ outcomes as patients enter third decade after surgery
The Ross procedure is associated with “excellent” clinical outcomes more than two decades after treatment, according to new long-term data published in JAMA Cardiology.[1]
“In the search for an ideal aortic valve substitute, insights into long-term survival and clinical outcomes remain of utmost importance to guide decision-making,” wrote first author Maximiliaan L. Notenboom, BSc, with the department of cardiothoracic surgery at Erasmus University Medical Center in the Netherlands, and colleagues.
Notenboom et al. focused on data from 108 adult patients who underwent the Ross procedure for aortic valve disease (AVD) at a single facility from September 1994 to May 2001. The median age was 38 years old. While 45% patients were treated primarily for aortic regurgitation (AR), 28% were treated primarily for aortic stenosis (AS) and another 27% were treated for a mix of AS and AR.
The median follow-up period for this analysis was 24.1 years. One patient died during the procedure, and 16 patients died during the follow-up period. Sixty-nine percent of those deaths were cardiac in nature, 19% were noncardiac and the remaining 13% are unknown.
Survival after 25 years was 83%, which the authors said represented a relative survival rate of 99.1% compared with a matched population of patients. Meanwhile, freedom from reintervention after 25 years was 71.1%.
In terms of valve-related complications, there were nine cases of homograft endocarditis and one case of autograft endocarditis. There were no reports of late bleeding, thromboembolism, valve thrombosis or cerebrovascular events. Even after nearly 25 years, 86% of patients presented with a New York Heart Association functional classification of I or II.
“This study found that in adults with AVD, the Ross procedure provided excellent survival into the third decade after surgery that was equivalent to that in the general population,” the authors concluded. “Additionally, long-term freedom from reintervention demonstrates that the autograft is a durable aortic valve substitute into late adulthood, showing a delayed but progressive decline in function. These data further support the unique benefits of a living valve substitute in adults and suggest that this effect sustains into the third postoperative decade.”
Click here to read the full study in JAMA Cardiology.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.