Results of a Multimodal Approach for the Launch of a Ross Program.

Background: There has been renewed interest in the Ross procedure in young patients with aortic valve disease. We describe the details and results of a systematic strategy to launch a new Ross program.

Methods: Our department developed a multidisciplinary educational program that involved all practitioners involved in the care of potential Ross patients. A core group of surgeons underwent extensive hands-on technical preparation. Selection of patients was reviewed by a multidisciplinary team. Patient characteristics, operative details, and postoperative outcomes were analyzed.

Results: Between March 2021 and March 2022, 22 consecutive patients underwent Ross procedure at our institution. The mean age of the patients at time of operation was 40.4 ± 10.2 years, and most patients had no medical comorbidities (12/22). The most common indication for operation was aortic stenosis (13/22), followed by mixed aortic stenosis and aortic insufficiency (7/22). There were no deaths. Postoperatively, no patient required blood transfusion or reexploration for hemorrhage. All patients were discharged home on mean hospital day 5.9 ± 1.1. On predischarge echocardiography, there was a significant reduction in mean aortic gradients preoperatively to postoperatively (49 ± 20 mm Hg vs 4 ± 1 mm Hg; < .01) without aortic insufficiency or a change in left or right ventricular function.

Conclusions: We demonstrate that with multidisciplinary education and extensive hands-on surgical preparation under proctored supervision, a Ross program can be initiated safely with excellent short-term results and perioperative risk that mimics that of conventional surgical aortic valve replacement.