The Ross procedure: Current registry results

Background. The pulmonary autograft procedure for the treatment of aortic v alve disease was developed and performed by Ross in 1967. The results he pu blished in 1987 prompted increasing interest in the procedure. The Internat ional Registry of the Ross Procedure was established in 1993 to further exa mine longitudinal clinical outcomes. Methods. The results from the Ross registry document the continued and grow ing interest in the procedure with 2,523 patients currently enrolled, repre senting 122 centers and 166 surgeons worldwide. Results. Mortality (1987 to present) reported in the registry is 2.5%. It s hould be noted that follow-up stands at 70%. The most important issues for the registry to track are the incidence of reoperation for autograft failur e and the fate of the pulmonary homograft. Reoperation for all valve-relate d problems is low (5.4%), with an autograft explant rate of 1.9%. Overall r egistry data indicate that the right ventricular outflow tract revision rat e is 2.8% , with this decreasing by half to 1.3% in the 1987 to present sub group. Conclusions. Rigorous analysis of outcomes is difficult with registry follo w-up currently at 70%; however, the general conclusions derived from the re gistry are supported by other individual series with excellent followup. Su ccess of the registry depends on judicious efforts by all participating sur geons and coordinators in documenting long-term patient results and reporti ng them to the registry. (C) 1998 by The Society of Thoracic Surgeons.