Purpose of review: To update the long-term results of the Ross procedure in adults and to establish the current role of this operation for the management of aortic valve disease.
Recent findings: Early outcomes continue to be excellent. Follow-up beyond 10 years, however, demonstrates continued deterioration of the autografts and need for reoperation in a substantial percentage of patients, particularly those in whom the root replacement technique was used.
Summary: Until the long-term results of alternatives to the aortic root technique for implantation (i.e., subcoronary) become available, and until the long-term results with other techniques, such as implantation of the autograft root within a synthetic vascular graft, are known, the Ross procedure should not be routinely performed in adult patients.