Revisiting the Ross operation: early results from a new Ross program at a cardiovascular center in South America
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By
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Santiago Besa
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Álvaro Torres
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Pedro Ugarte
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Cecilia Romero
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Rodrigo González
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Pedro Becker
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Günther Krögh
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June 15, 2026
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Clinical Scorecard: Evaluating Early Outcomes of the Ross Procedure: Insights from a New Program at a Cardiovascular Center in South America
At a Glance
| Category | Detail |
|---|
| Condition | Aortic valve disease |
| Key Mechanisms | Replacement of the diseased aortic valve with the patient's own pulmonary autograft, reconstruction of the right ventricular outflow tract. |
| Target Population | Young and middle-aged adults (<60 years) with non-repairable aortic valve disease. |
| Care Setting | High-complexity university hospital in Latin America. |
Key Highlights
- 29 patients underwent the Ross procedure, with 86.2% having bicuspid aortic valves.
- Main surgical indications: severe aortic stenosis (34.5%), mixed lesions (34.5%), severe aortic regurgitation (27.6%).
- Early complications included perioperative stroke in 10.3% of patients.
- No severe autograft or homograft regurgitation was observed postoperatively.
- Median follow-up of 295 days showed no deaths and 1 reintervention due to homograft endocarditis.
Guideline-Based Recommendations
Diagnosis
- Eligibility assessed based on age, absence of connective-tissue disorder, and life expectancy.
Management
- Consideration of individual anatomical characteristics and patient preference for anticoagulation-free solutions.
Monitoring & Follow-up
- Echocardiographic follow-up to assess neoaortic and neopulmonary gradients.
Risks
- Potential for perioperative complications such as stroke and endocarditis.
Patient & Prescribing Data
Adults undergoing the Ross procedure for aortic valve disease.
The procedure provides a living valve substitute capable of growth and adaptation, avoiding lifelong anticoagulation.
Clinical Best Practices
- Dedicated training for surgeons performing the Ross procedure.
- Consistent perfusion, anesthesia, and nursing team for all cases.
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