Complications Following the Ross Procedure

Abstract

Aortic valve replacement with a pulmonary autograft (ie, Ross procedure) is a technique used in selected cases for the treatment of aortic valve disease. Aware of reports describing chronic complications after the Ross procedure such as aortic insufficiency, right ventricular outlet obstruction, aortic autograft dilatation, and pulmonary allograft stenosis, cardiac magnetic resonance imaging (MRI) was performed in individuals who had a previous Ross procedure (range 2 to 10 years earlier) to determine if these complications could be visualized by MRI. This case study presents the MRI findings of 5 patients (mean age: 42.0+/-7.8 years). In each patient, complications of the Ross procedure were observed. These results suggest that cardiac MRI has the potential to become a clinically important technique for evaluating post-Ross procedure patients.

Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology

“…Any jet formation should be visualized by cine imaging and quantified by jet velocity mapping, and regurgitation measured by through-plane velocity mapping. 51,52 The autograft valve in the aortic position should also be assessed for possible dilatation and regurgitation particularly in the second decade after operation. 53 Possible sub-valvular pseudo-aneurym formation at the proximal suture line should be sought.…”

Measurement of Pulmonary Circulation Parameters Using Time-Resolved MR Angiography in Patients After Ross Procedure

“…Grotenhuis et al [6] have shown that MRI-derived measurements of aortic root diameter, aortic root distensibility, and aortic regurgitation correlate with LV dysfunction in patients after the Ross procedure. Crowe et al [7] have shown right-heart complications of the Ross procedure using MRI; these include pulmonary valve stenosis (Fig. 2), pulmonary regurgitation, main pulmonary artery obstruction, and RV dysfunction.…”