The Ross Procedure for Replacement of the Bicuspid Aortic Valve: Mid-Term Results from 55 Consecutive Cases
Francesco Santini MD, Giovanni Battista Luciani MD, Luca Barozzi MD, Mario Lusini MD, Stefania Trimboli MD, Stefano Restivo MD, Alessandro Mazzucco MD

Between July 1994 and December 2000, 55 patients (mean age 27 ± 10 years) underwent replacement of a diseased bicuspid aortic valve (stenosis 11%, insufficiency 65%, mixed 24%) with a pulmonary autograft (subcoronary implant 4%, root 73%, cylinder 23%). No early or late deaths occurred at a mean follow up of 31 ± 19 months. Fifty-three patients (97%) showed no or trivial aortic insufficiency (AI) at serial echocardiographic controls. One patient required reoperation for moderate AI after a subcoronary implant. Three patients (5%) in the root subgroup showed mild neoaortic root dilatation after two years follow up. The Ross procedure represents a low-risk alternative for adolescents and young adults with bicuspid aortic valve. The inclusion cylinder technique might reduce incidence of root dilatation. Continued patient evaluation in the long term is warranted.