The Ross Operation in Children and Young Adults: 12-Year Results and Trends From the UK National Database

World J Pediatr Congenit Heart Surg. 2014 Jul;5(3):406-12. doi: 10.1177/2150135114537532.

Abstract

Objectives: To determine UK national trends and results of the Ross operation in relation to all aortic valve interventions.

Methods: Examination of the UK Congenital Central Cardiac Audit Database for all aortic valve procedures performed between 2000 and 2011 in children (0-16 years) and young adults (16-30 years).

Results: A total of 2,206 aortic valve procedures were performed in children and 1,824 in young adults, the proportions in the two groups being: Ross operation (19% vs 15%, respectively), surgical valvoplasty (9.5% vs 4%), surgical valvotomy (9.5% vs 1%), aortic valve replacement (AVR; 11% vs 55%), aortic root replacement (4% vs 18%), and balloon valvoplasty (47% vs 7%). The 30-day and 1-year survival after Ross is 99.3% and 98.7%, respectively, in the last four years achieving 100%. In children, the proportion of balloon valvoplasty increased from an average of 43% in 2000 to 2006 to 53% in 2007 to 2011, whereas the Ross operation decreased from 22% to 16% (P < .001). In young adults, the figures are an increase from 49% to 58% for AVR compared to a decrease from 23% to 9% for Ross (P < .001). Our own single-center series of 91 patients also shows standard results for early- and long-term survival and freedom from reoperation, but gradually fewer Ross operations performed. The year-on-year changes show a significant decreasing trend locally and nationally.

Conclusions: Despite an excellent track record, the Ross operation is performed less frequently in the United Kingdom. This report is a first step in comparing treatment modalities at national level.

Keywords: Ross operation; aortic valve; autograft; heart valve; morbidity); outcomes (includes mortality; replacement.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Forecasting*
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation / trends*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Registries*
  • Second-Look Surgery / methods*
  • United Kingdom
  • Young Adult