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Valvular & structural heart disease

The Ross Renaissance

JACC AdvPublication date not resolved

Main finding · Composite of in-hospital mortality, stroke, prolonged mechanical ventilation, reoperation, acute kidney injury, sepsis, cardiac arrest, and venous thromboembolismAdjusted odds ratio 0.65 95% CI 0.46–0.91
  • Retrospective analysis of the 2010-2022 Nationwide Readmissions Database
  • age-matched using coarsened exact matching
  • multivariable regression
+2 more
  • age-matched using coarsened exact matching
  • multivariable regression
Read the original article ↗

Authors' conclusion

The Ross procedure is undergoing a resurgence in pediatric and adult populations, with favorable short-term outcomes and comparable costs to SAVR. These findings support broader adoption of the Ross operation at experienced centers for appropriately selected patients.

Study context

Population
Adult and pediatric patients undergoing elective aortic valve replacement
Participants
109,235 valve replacements
Exposure
Ross procedure vs surgical aortic valve replacement (SAVR)
Outcome
Composite of:
  • In-hospital mortality
  • Stroke
  • Prolonged mechanical ventilation
  • Reoperation
  • Acute kidney injury
  • Sepsis
  • Cardiac arrest
  • Venous thromboembolism

Main finding

As reported in the abstract

Composite of:
  • In-hospital mortality
  • Stroke
  • Prolonged mechanical ventilation
  • Reoperation
  • Acute kidney injury
  • Sepsis
  • Cardiac arrest
  • Venous thromboembolism

Adjusted odds ratio

0.65

95% CI 0.46–0.91

Ross vs SAVR
adjusted OR 0.65 (95% CI 0.46–0.91)

Observational data: associations, not effects.

Further findings

Outcomeadjusted OR (95% CI)
Stroke · lower odds with Ross · after age-matching and risk adjustment0.38 (0.18–0.80)

Nonhome discharge and 30-day readmissions

Lower nonhome discharge and lower 30-day readmissions with Ross

Hospitalization costs

Not significantly different between groups

Share of Ross procedures among valve replacements

Adult cases
1.5%
Pediatric cases
37.2%

Ross utilization over time

Increased significantly over time across age groups
P < 0.001

Baseline characteristics

Ross recipients younger, with fewer comorbidities, often treated at high-volume teaching hospitals

Original publication

The Ross Renaissance. JACC Adv. doi:10.1016/j.jacadv.2025.102478
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it