German ROSS registry – annual report

Objectives: Despite encouraging reports concerning morbidity and mortality of the ROSS procedure complete recordation of procedure- and patient-associated factors are essential for quality assurance. The German Ross Registry, founded in 2002, pursue this policy.

Material and Methods: 734 data sets from seven participating hospitals are recorded. The monitoring completeness was 96.7%.

Results: Preoperatively 2/3 of the patients were mild- or asymptomatic. LV-function was moderate or more reduced in 7%. Additional surgical procedures were performed in 38%. Hospital mortality was low (0.7%), as it was for non-fatal complications (7.4%). 592 patients were followed for at least one year. After a follow-up of 3.8±2.4 years less than 1/3 of the patients had heart-associated complains, primarily minor symptoms, therefore the contentedness was exceptionally hight. Postoperative complications occurred in 72 patients (12.2%). Cardiac surgical reinterventions were necessary in 36 patients (ROSS-related, n=33; not ROSS-related, n=3). 13 patients died in late follow-up, in 8 of them extracardiac diseases were causative. Postoperative echocardiography showed a significant reduction of LV-mass and of the LV-dimensions in systole and diastole. The maximum pressure gradient across the autograft was 6.6±4.5mmHg, mean 3.6±2.4mmHg, aortic regurgitation ≥1° could be seen in 16 pts. (3.0%). The mean pressure gradient across the homograft was 8.8±6.2mm Hg, in 35 pts. the max gradient exceeded 31mmHg. Regurgitations >1° occurred in 39 pts. (7.6%).

Conclusions: This descriptive evaluation of the ROSS-procedure during a mid-term follow-up period represents a promising basis for a long-term evaluation of this surgical method. Direct comparison with other valve replacement techniques may be limited because of favourable hemodynamic and demographic characteristics of the „ROSS-cohort“, subgroups has to be defined.