Vol. 25 No. 3 (2021)
ACQUIRED HEART DISEASES

Five-year outcomes of the modified Ross surgery in adults: experience from one center

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  • I.I. Chernov,
  • S.T. Enginoev,
  • D.A. Kondratyev,
  • D.Yu. Kozmin,
  • V.V. Demetskaya,
  • E.R. Aliev,
  • D.G. Tarasov
I.I. Chernov
Federal Center for Cardiovascular Surgery, Astrakhan
S.T. Enginoev
Federal Center for Cardiovascular Surgery, Astrakhan; Astrakhan State Medical University, Astrakhan
Bio
D.A. Kondratyev
Federal Center for Cardiovascular Surgery, Astrakhan
D.Yu. Kozmin
Federal Center for Cardiovascular Surgery, Astrakhan
V.V. Demetskaya
Federal Center for Cardiovascular Surgery, Astrakhan
E.R. Aliev
Astrakhan State Medical University, Astrakhan
D.G. Tarasov
Federal Center for Cardiovascular Surgery, Astrakhan
DOI: https://doi.org/10.21688/1681-3472-2021-3-43-50

Published 2021-09-28

Keywords

  • acquired heart disease,
  • aortic regurgitation,
  • Ross operation

How to Cite

Chernov, I., Enginoev, S., Kondratyev, D., Kozmin, D., Demetskaya, V., Aliev, E., & Tarasov, D. (2021). Five-year outcomes of the modified Ross surgery in adults: experience from one center. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 25(3), 43–50. https://doi.org/10.21688/1681-3472-2021-3-43-50

Copyright (c) 2021 Chernov I.I., Enginoev S.T., Kondratyev D.A., Kozmin D.Yu., Demetskaya V.V., Aliev E.R., Tarasov D.G.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background. The Ross operation was first proposed in 1967 by D. Ross, and numerous studies have shown that it has excellent long-term results. However, in some patients, it can lead to late dilatation of the pulmonary autograft, which in turn can contribute to repeat operations. To avoid this complication, technical modifications of the Ross operation have been proposed.
Aim. To evaluate the immediate and five-year outcomes of the modified Ross surgery in adults.
Methods. This retrospective study included patients aged 18 years and older with aortic valve lesions who underwent a modified Ross procedure by one surgeon between January 2014 and December 2019. The median follow-up period was 23 (12–68) months.
Results. The study included 43 adult patients. The average age of the patients was 40.0 ± 11.7 years, and 33 (76.7%) were men. The main cause of aortic valve dysfunction was severe aortic regurgitation (32 patients, 74.4%). Infective endocarditis was diagnosed as a cause of aortic valve pathology in 13 (30.2%) patients. Bicuspid aortic valve was present in 29 cases (67.4%). In two cases (4.7%), mini-sternotomy (‘T-shape’) was performed. Ten (23.2%) patients underwent combined interventions. The median duration of cardiopulmonary bypass was 143 (129–160) minutes, and duration of aortic cross-clamp was 116 (109–131) minutes. The autologous inclusion technique was used in 22 (51.2%) cases and the Dacron inclusion technique in 21 (48.8%) cases. Outcomes included no in-hospital mortality, acute renal failure requiring haemodialysis in three patients (7%), pacemaker implantation in two (4.7%), resternotomy for bleeding and stroke in one patient (2.3%) and perioperative myocardial injury in two (4.7%). The five-year overall survival, freedom from reoperation and freedom from dilatation of the ascending aorta or pulmonary autograft ≥ 5 cm after the modified Ross operation were 97.4%, 100.0% and 100.0%, respectively.
Conclusion. Modified Ross surgery in adults has excellent immediate outcomes with no in-hospital mortality. The five-year overall survival, freedom from reoperation and freedom from aortic dilatation or pulmonary autograft were 97.4%, 100.0% and 100.0%, respectively.

Received 15 February 2021. Revised 3 June 2021. Accepted 4 June 2021.

Funding: The study did not have sponsorship.

Conflict of interest: The authors declare no conflicts of interests.

Contribution of the authors
Conception and study design: I.I. Chernov, S.T. Enginoev, D.A. Kondratyev, D.Yu. Kozmin
Data collection and analysis: E.R. Aliev, V.V. Demetskaya, D.A. Kondratyev, D.Yu. Kozmin
Statistical analysis: S.T. Enginoev
Drafting the article: I.I. Chernov, S.T. Enginoev
Critical revision of the article: I.I. Chernov, D.G. Tarasov
Final approval of the version to be published: I.I. Chernov, S.T. Enginoev, D.A. Kondratyev, D.Yu. Kozmin, V.V. Demetskaya, E.R. Aliev, D.G. Tarasov

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