Contemporary Outcomes of the Ross Procedure in Adults: Implications for Current Clinical Practice.
I, E.H., V, C., I, B., K, L., N, P., & P, D. (2026). Contemporary Outcomes of the Ross Procedure in Adults: Implications for Current Clinical Practice.. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2026.03.173
I EH, V C, I B, K L, N P, P D. Contemporary Outcomes of the Ross Procedure in Adults: Implications for Current Clinical Practice.. Journal of the American College of Cardiology. 2026; doi: 10.1016/j.jacc.2026.03.173
I EH, V C, I B, et al. Contemporary Outcomes of the Ross Procedure in Adults: Implications for Current Clinical Practice.[J]. Journal of the American College of Cardiology. 2026. DOI: 10.1016/j.jacc.2026.03.173.
@article{i2026,
author = {El-Hamamsy I and Chauvette V and Bouhout I and Louro K and Poirier N and Demers P},
title = {Contemporary Outcomes of the Ross Procedure in Adults: Implications for Current Clinical Practice.},
journal = {Journal of the American College of Cardiology},
year = {2026},
doi = {10.1016/j.jacc.2026.03.173},
note = {PMID: 42339796},
}
TY - JOUR AU - El-Hamamsy I AU - Chauvette V AU - Bouhout I AU - Louro K AU - Poirier N AU - Demers P TI - Contemporary Outcomes of the Ross Procedure in Adults: Implications for Current Clinical Practice. T2 - Journal of the American College of Cardiology PY - 2026 DO - 10.1016/j.jacc.2026.03.173 AN - PMID:42339796 ER -
BACKGROUND: With renewed enthusiasm for the Ross procedure in adults in recent years, long-term data using contemporary techniques are needed. OBJECTIVES: The purpose of this study was to evaluate long-term clinical and echocardiographic outcomes of the Ross procedure in a contemporary adult cohort. METHODS: From 2011 to 2019, 455 consecutive adults (mean age 47 ± 12 years; 73% male) underwent a Ross procedure at a single high-volume tertiary center. This includes our inaugural experience with the procedure. All patients were prospectively followed with systematic clinical and echocardiographic follow-up. Outcomes included operative safety, long-term survival, reinterventions, valve hemodynamics, and autograft root dimensions. Median follow-up was 9.0 years (Q1-Q3: 7.3-11.1 years), with 98% completeness of clinical and echocardiographic follow-up (4,191 patient-years and 2,921 echocardiograms). RESULTS: Operative mortality was 0.4% (n = 2). No patient-prosthesis mismatch occurred, and permanent pacemaker implantation was required in 0.8% (n = 3). At 12 years, actuarial survival was comparable to the age- and sex-matched general population. The cumulative incidence of autograft reintervention at 12 years was 1.1% ± 0.5%, with no difference between patients with preoperative aortic regurgitation and aortic stenosis (1.2% ± 1.2% vs 1.1% ± 0.6%; P = 0.39, respectively). The cumulative incidence of pulmonary homograft reintervention at 12 years was 1.9% ± 0.9%, and any cardiac reintervention was 3.5% ± 1.0% at 12 years. Mean aortic valve gradient at 12 years was 4.0 ± 0.2 mm Hg. CONCLUSIONS: In a large contemporary adult cohort with comprehensive follow-up, the Ross procedure was associated with excellent long-term survival, durable valve performance, and low reintervention rates, including in patients with preoperative aortic regurgitation and those >50 years of age. These findings provide an important contemporary benchmark and support broader consideration of the Ross procedure in appropriately selected adults in experienced centers.