Valvular & structural heart diseaseCohort study

Use of the Ross Procedure in North America

J Am Coll CardiolPublished

  • Retrospective cohort study
  • registry database
  • multicentre

Authors' conclusion

The Ross procedure is increasingly utilized in North America. Outcomes appear more favorable in higher-volume centers and surgeons, supporting the view that experience may play a key role in achieving optimal results.

Study context

Population
Adults undergoing the Ross procedure, STS Adult Cardiac Surgery Database, 2008–2023
Participants
2,268 adults · 194 centers
Exposure
Higher vs lower center- and surgeon-level Ross volume
Outcome
Trends in Ross procedure utilization and relationship between Ross volumes and operative mortality

Main finding

As reported in the abstract

Ross utilization nadir in 2017 (n)
63
Ross cases in 2023
531
Ross share of AVR in adults ≤60 years, 2017
0.9%
Ross share of AVR in adults ≤60 years, 2023
6.7%
Operative mortality 2008
4.4%
Operative mortality 2020
1.0%
Operative mortality 2023
2.5%
Higher center- and surgeon-level Ross volume associated with lower operative mortality
P < 0.001
Substantial improvements beyond approximately cases per year
10

Observational data: associations, not effects.

Further findings

Procedures per center over 16 years

Median number of procedures per center (Q1-Q3: 1-7)
2

Original publication

Use of the Ross Procedure in North America. J Am Coll Cardiol. Published 4 March 2026. doi:10.1016/j.jacc.2026.01.031

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