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Artigo Acesso aberto Produção Nacional Revisado por pares
BIBTEX RIS

20 years experience with the Ross operation in middle-aged patients: the autologous principle is still alive

2016; Oxford University Press; Linguagem: Inglês

10.1093/icvts/ivw365

ISSN

1569-9293

Autores

Francisco Diniz Affonso da Costa, Daniele Fornazari Colatusso, Eduardo Mendel Balbi Filho, Rafael Marchetti, Andreia Dumsch de Aragon Ferreira, Marise Brenner Affonso da Costa, João Gabriel Roderjan, Claudinei Colatusso,

Tópico(s)

Aortic Disease and Treatment Approaches

Resumo

Review our long-term results with the Ross operation in middle-aged patients.Between 1995 and 2016, 129 consecutive patients (106 males); mean age (47.2 ± 5.2 years) underwent a Ross operation. Right ventricular outflow tract (RVOT) reconstruction was performed with cryopreserved (n = 45) or decellularized allografts (n = 84). Mean follow-up was 8.4 ± 5.3 years (0.1 20.5 years). We analyzed early and late mortality, as well as valve related events and the need for reoperations.Early mortality was 1.6% and late survival was 87.6% at 16 years. There were 4 reoperations on the pulmonary autograft (96% freedom at 16 years) and 2 on the pulmonary allografts (99% freedom at 16 years). The 16-year freedom from more than mild aortic insufficiency (AI) and a late root diameter >45 mm was 64% and 71%, respectively. Patients with the preoperative diagnosis of AI are at greater risk for these complications. Among the allografts, decellularized allografts showed superior freedom from structural valve dysfunction.The Ross operation in this cohort was associated with long-term survival similar to the general population and low incidence of reoperations. Patients with the preoperative diagnosis of AI are at increased risk for late autograft insufficiency and root dilatation. Decellularized allografts presented the best results for reconstruction of the RVOT. These results support the conclusion that the Ross operation has an important role in the treatment of middle-aged patients with aortic valve disease, especially those with pure aortic stenosis.

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