Ross procedure in patients with severe left ventricular systolic dysfunction

The Ross procedure outcomes in patients with left ventricular dysfunction are presented. 20 Ross procedures were performed in patients with aortic disease complicated by severe left ventricular dysfunction. The average left ventricular ejection fraction before surgery was 31,56,57%. Aortic stenosis was found in 60% of cases. Hospital mortality rate was 5%. Heart failure prevailed among complications. It was already in the early postoperative period that significant left ventricular remodeling was observed. The patients with aortic stenosis demonstrated a 56,9 % increase in ejection fraction, while their end-systolic diameter and end-systolic volume decreased by 34,5% and 13,3% respectively. In the group with aortic insufficiency there was a statistically significant reduction in the left ventricular volume indices: left ventricular end-diastolic diameter by 20%, left ventricular end-diastolic volume by 36,5%. No reoperation due to dysfunction of the autograft and conduits in the pulmonary artery area was required. At 12 months after surgery the processes of left ventricular cavity remodeling and normalization of contractility in both groups continued. The results of this study show that the Ross procedure can be used successfully in patients with severe left ventricular systolic dysfunction.