Valvular & structural heart disease
Use of the Ross Procedure in North America: Relation Between Surgical Volume and Operative Mortality
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
Methodological detailsregistry database, multicentre
- Registry database
- Multicentre
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: Relation Between Surgical Volume and Operative Mortality. J Am Coll Cardiol. Published 4 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it