• Vincent Chauvette, German J Chaud, Charles Laurin, Mohamed Marzouk, Dimitri Kalavrouziotis, Siamak Mohammadi, Philippe Pibarot, and Jean Perron.
• Department of Cardiac Surgery, Université de Montréal, Montreal, Quebec, Canada.
• J. Thorac. Cardiovasc. Surg. 2024 Jul 27.

ObjectivesTo assess the long-term outcomes of patients undergoing a Ross procedure in the context of a redo aortic valve (AV) surgery.MethodsProspectively collected data in all consecutive adults who underwent a Ross procedure were analyzed to compare the Ross procedure performed as a first surgery (RF) or as a redo surgery (RP).ResultsBetween 1990 and 2021, 395 Ross procedures were performed at our center (RF, n = 345; RP, n = 50). A 2:1 propensity score matching was performed (RF, n = 100; RP, n = 50). The overall median follow-up was 11.6 years (interquartile range, 5.0-21.8 years) and 100% complete. Mean survival at 20 years was 87 ± 12% in the RF group and 87 ± 8% in the RP group (P = .30). The cumulative incidence of autograft reintervention at 10 years and 20 years was 6 ± 3% and 21 ± 6%, respectively, in the RF group and 9 ± 5% and 25 ± 8%, respectively, in the RP group (P = .74). The AV gradient remained stable up to 20 years in both groups (P = .42). The size of the sinuses of Valsalva tended to increase over time in the RF group but remained stable in the RP group (P = .03).ConclusionsThe ross procedure after a previous sternotomy for AV surgery is safe and offers good long-term results. Patients undergoing redo AV intervention have similar results as patients undergoing a primary Ross procedure, perhaps with a lower risk of autograft dilatation.Copyright © 2024 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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