The Ross operation in children. Results from the European Ross Registry [Die Ross-Operation bei Kindern. Ergebnisse aus dem Europäischen Ross-Register]

Objectives: To determine the durability of autografts and homografts after Ross operations in children. Patients and methods: The data of 152 children <16 years were analyzed using the Cox proportional hazards model and hierarchical multilevel modeling. Results: Autograft regurgitation increased with sinotubular junction diameter (p=0.028). The homograft gradient increased within the first 2 years (4.2 mmHg/year, p<0.001). Freedom from autograft and homograft reintervention at 10 years was 95.5±2.7% and 79.6±6.1%, respectively. Longer follow-up time was a risk factor for autograft reintervention (p=0.036). Use of an aortic homograft was a risk factor for conduit reintervention (p=0.013). Conclusions: Reinterventions are necessary for autograft regurgitation and homograft stenosis. Increasing sinotubular junction diameters explain autograft regurgitation. Using pulmonary homografts delays the development of a homograft gradient.