The Ross Operation in 225 Patients: A Five-Year Experience in Aortic Root Replacement
Jürgen O. Böhm MD, Cornelius A. Botha MD, Wolfgang Hemmer MD, Detlef Roser MD, Christoph T. Starck MD, Joachim-Gerd Rein MD

The Ross operation has undergone several modifications, thereby improving both technical feasibility and results. Among 225 patients who received the Ross procedure at the authors’ institution between February 1995 and December 2000, four required reoperation in the long-term due to autograft regurgitation (autograft repair in one patient, autograft replacement in three patients). It was considered that routine aortic annulus support, a lowered threshold to replace all dilated ascending aorta and keeping the autograft short prevented further autograft failure. Pulmonary homograft stenosis led to reoperation in one patient. Six patients with elevated gradients are under continual re-evaluation. Echocardiography revealed near-physiological gradients across both the autograft and homograft, and no significant regurgitation in all patients. One patient was recently diagnosed with AI (grade >2). In conclusion, excellent mid-term hemodynamic results, low morbidity and reoperation rate support the evolved root replacement technique and justify its further utilization.