10 YEARS OF EXPERIENCE WITH THE MODIFIED ROSS PROCEDURE

Background: To assess the full root modification of the Ross procedure , we examined operative and long-term results. Methods: We retrospecti vely reviewed 145 patients (118 men and 27 women) operated on from Mar ch 1987 through April 1997. Ages ranged from 17 to 68 years. Primary d iagnosis was aortic stenosis in 43 patients (29.6%) and aortic regurgi tation in 62 patients (42.8%). There was mixed disease (stenosis and r egurgitation) in 40 patients (29.6%) of whom the vast majority had pre dominant stenosis. Results: Early death was 7 of 145 patients (4.8%). Twelve patients had 14 significant complications (8.5%). There were fo ur fate deaths. Overall patient survival is 90.5% +/- 3.1% at 5 years and 84.5% +/- 14.1% at 7 years. Endocarditis occurred in three patient s-two on the autograft and one on the pulmonary homograft. Three patie nts had cerebrovascular accidents. In 5 of 132 patients (3.8%) reopera tions were required on the autograft. Freedom from autograft reoperati on was 93.9% +/- 3.1% at 5 years and 88.6% +/- 6.4% at 7 years. Echoca rdiographic follow-up reveals more than mild aortic regurgitation in o nly nine patients, including the five patients in whom reoperations we re required. Seven of 11 patients with active endocarditis at the time of the operation had adverse outcomes. Conclusions: Ten years' experi ence with the modified Ross procedure has shown excellent results with regard to short-and long-term morbidity and death. It is the procedur e of choice for young patients who need aortic valve replacement but s hould be used with caution in the setting of active endocarditis.