Abstract
OBJECTIVE: To compare outcomes of the Ross procedure in patients older than and younger than 50 years of age. METHODS: This is a review of patients who underwent a Ross procedure at a participating site in the North American Ross Consortium. Data were analyzed for differences in short- and medium-term outcomes. RESULTS: Total cohort size was 477 patients, with n = 350 <50 years old and n = 127 ≥50 years. The median age of the entire cohort was 41 years; 37 in the <50 years cohort and 54 in the ≥50 years cohort (P < .001). Patients in the <50 years cohort had lower body mass index (26.9 vs 28.7, P = .001) and had lower rates of preoperative hypertension (28% vs 52%, P < .0001). Perioperative outcomes were similar between groups. There was a greater rate of postoperative atrial fibrillation/flutter (24% vs 9.25%, P < .001) and stroke (3.97% vs 0%, P = .002) in the ≥50 years cohort; however, in-hospital mortality was 0.63% in the entire cohort and was similar between groups (≥50 years= 1.59%, <50 years = 0.29%, P = .174). Freedom from valve-related reintervention was 84% over the first decade and did not differ between cohorts. Overall survival at 60-months demonstrated improved survival in the <50 years cohort (97% vs 94%, P < .001); however, was overall excellent at 96%. CONCLUSIONS: The Ross procedure can be safely performed in patients older than 50 years in select centers. There is a greater risk of stroke and postoperative atrial fibrillation/flutter in older patients; however, perioperative survival is similar.