Acceptance and versatility of the Ross procedure

During the 31 years since the initial Ross procedure, data have been collec ted that have been helpful in assessing long-term performance of the autogr aft. The ongoing study of the pulmonary autograft supports the use of the R oss procedure in young patients, in females of childbearing age, and in pat ients with congenital aortic stenosis and complex left ventricular outflow tract obstruction. We continue to see little or no thromboembolism despite no anticoagulation therapy. The remarkable ability of the autograft to grow in children is extremely beneficial. Additionally excellent results have b een obtained in some series for the treatment of endocarditis. Recently, th e autograft has performed similarly to a normal aortic valve under high str ess. Changes in implantation techniques transitioning from subcoronary to r oot replacement and performing annular narrowing has decreased the incidenc e of early regurgitation. A potential for an immune response with resulting pulmonary stenosis and possible early explantation of the pulmonary homogr aft exists; however, overall, results of the Ross procedure are excellent a nd highly reproducible.