Exercise Hemodynamic Performance of the Pulmonary Autograft Following the Ross Procedure Graeme F. Porter FRACP, Peter D. Skillington FRACS, Andrew R. Bjorksten PhD, John G. Morgan MBBS, Anthony G. Yapanis MBBS, FRACP, Leeanne E. Grigg FRACP The Ross procedure is considered an excellent alternative for younger patients requiring elective aortic valve replacement. Pulmonary autograft function at rest as assessed by Doppler echocardiography (DE) is good, but limited data exist on exercise hemodynamic function. Using exercise DE, we studied 24 pulmonary autograft patients at 25 ± 14 months after performing the Ross procedure. Ten age-matched normal controls and five mechanical-valve patients were studied for comparison. Both at rest and after exercise, pulmonary autograft patients had similar peak and mean gradients to normal controls, whereas mechanical-valve patients had significantly higher peak and mean gradients. The effective orifice area of the pulmonary autograft, when indexed to body surface area, was similar to that of the normal aortic valve, and did not change significantly after exercise. The results show the exercise hemodynamic performance of the pulmonary autograft to be similar to that of the normal aortic valve.

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