{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:22:24Z","timestamp":1792452144136,"version":"4.5.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The Ross procedure allows the replacement of a diseased aortic valve with a living valvular substitute and provides a normal life span. However, progressive autograft dilatation and subsequent neoaortic valve regurgitation leading to reoperations remain major drawbacks. Our objective was to assess the long-term outcomes of our modified Ross technique with pulmonary autograft reinforcement in a Valsalva Dacron graft.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Data from all patients who underwent a modified Ross procedure in our institution between 2003 and 2020 were reviewed retrospectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>One hundred eighty-nine patients were included in this study. Median age at surgery was 31\u2009years [interquartile range (IQR) 22.5\u201338.7]. Patients were predominantly male (74.1%) and with bicuspid aortic valve (90.5%). Indication for surgery was pure aortic regurgitation in 40.2%, pure aortic stenosis in 30.7%, mixed lesion in 26.5% and prosthetic valve failure in 2.7%. Median cardiopulmonary bypass and aortic cross-clamping times were 135 (IQR 120\u2013171.5) and 114 (IQR 101.5\u20131423.5) min, respectively Three perioperative deaths occurred (1.6%). Median follow-up was 8.6\u2009years (IQR 5.3\u201311.5); three late deaths occurred. Overall survival rate was 96.6% at both 5 and 10\u2009years. Ten patients underwent 11 late autograft reinterventions. Freedom from autograft reoperation was 95.8% and 95.0% at 5 and 10\u2009years, respectively. The main indication for autograft reoperation was neoaortic regurgitation due to cusp prolapse. With death as a competing outcome, we observed a trend towards an increased risk for autograft reintervention in patients with pure preoperative aortic regurgitation (sub-hazard ratio 4.47, P = 0.057; 95% confidence interval 0.95\u201320.9).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The modified Ross procedure with inclusion of the pulmonary autograft using a Valsalva Dacron graft showed excellent results at 10\u2009years.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf133","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T19:27:21Z","timestamp":1744313241000},"source":"Crossref","is-referenced-by-count":5,"title":["Modified Ross procedure with pulmonary autograft reinforcement within a Valsalva Dacron graft: long-term results"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0470-8619","authenticated-orcid":false,"given":"Thomas","family":"Denisselle","sequence":"first","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Jungling","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]},{"name":"ULR 2694-Technologies de Sant\u00e9 et des Pratiques M\u00e9dicales, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natacha","family":"Rousse","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Juthier","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Prat","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Loobuyck","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agn\u00e8s","family":"Mugnier","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Monier","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Banfi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Istituto Clinico Sant'Ambrogio, Gruppo Ospedaliero San Donato Milan, University of Milan , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Domanski","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Godart","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjorie","family":"Richardson","sequence":"additional","affiliation":[{"name":"Clinical Physiology and Echocardiography, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustin","family":"Coisne","sequence":"additional","affiliation":[{"name":"Clinical Physiology and Echocardiography, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouhamed Djahoum","family":"Moussa","sequence":"additional","affiliation":[{"name":"ULR 2694-Technologies de Sant\u00e9 et des Pratiques M\u00e9dicales, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]},{"name":"Cardiovascular Anesthesia and Intensive Care, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Robin","sequence":"additional","affiliation":[{"name":"Cardiovascular Anesthesia and Intensive Care, Universit\u00e9 de Lille, CHU Lille , Lille,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4014-3132","authenticated-orcid":false,"given":"Jerome","family":"Soquet","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery Unit, Royal Adelaide Hospital , Adelaide,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4081-786X","authenticated-orcid":false,"given":"Andr\u00e9","family":"Vincentelli","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Universit\u00e9 de Lille, CHU Lille , 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