Long-Term Results of Patients Undergoing a Ross Procedure After a Previous Aortic Valve Surgery.

To assess the long-term outcomes of patients undergoing a Ross procedure in the context of a redo aortic valve surgery. Prospectively collected data in all consecutive adults who underwent a Ross procedure were analyzed to compare the Ross procedure as a first surgery (RF) and as a redo (RP) surgery. Between 1990 and 2021, 395 Ross procedure were performed at our center (RF 345 and RP 50). A 2:1 propensity-match was performed (100 in RF group and 50 in RP group). The overall median follow-up is 11.6 [IQR 5.0-21.8] years and 100% complete. Survival was 87±12% in the RF group and 87±8% in the RP group at 20 years (p=0.30). The cumulative incidence of autograft reintervention was 6±3% and 21±6% in the RF group and 9±5% and 25±8% in the RP group at 10 and 20 years, respectively (p=0.74). Aortic valve gradient remained stable up to 20 years in both groups (p=0.42). The size of the sinuses of Valsalva tended to increase over time in the RF group, while it remained stable in the RP group (p=0.03). Ross procedure after a previous sternotomy for aortic valve surgery is safe and offers good long-term results. Patients undergoing redo aortic valve intervention have similar results compared to patients undergoing a primary Ross procedure with perhaps, a lower risk of autograft dilatation.

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