Evidence map›Paper›PMID 41609284›Full record

ArticleJACC. Advances2026

The Ross Renaissance: Trends and Short-Term Outcomes of the Ross Procedure in the United States.

Amulya Vadlakonda, Sara Sakowitz, Troy Coaston, Joseph Hadaya, Sidney Hinks, Ming-Sing Si, Peyman Benharash

Abstract read
PubMed Full text at PMC Publisher
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Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Amulya VadlakondaDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA; Cardiovascular Outcomes Research Laboratory, University of California, Los Angeles, California, USA.
Sara SakowitzDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA; Cardiovascular Outcomes Research Laboratory, University of California, Los Angeles, California, USA.
Troy CoastonDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA; Cardiovascular Outcomes Research Laboratory, University of California, Los Angeles, California, USA.
Joseph HadayaDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA; Cardiovascular Outcomes Research Laboratory, University of California, Los Angeles, California, USA.
Sidney HinksDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA; Cardiovascular Outcomes Research Laboratory, University of California, Los Angeles, California, USA.
Ming-Sing SiDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA.
Peyman BenharashDivision of Cardiac Surgery, Department of Surgery, University of California, Los Angeles, California, USA; Cardiovascular Outcomes Research Laboratory, University of California, Los Angeles, California, USA. Electronic address: pbenharash@mednet.ucla.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Ross procedure, involving pulmonary autograft replacement of the aortic valve, has remained underutilized. Recent technical advancements have prompted renewed interest in the Ross operation, particularly as an alternative to conventional surgical aortic valve replacement (SAVR).

objectivesThe purpose of this study was to examine national utilization of the Ross procedure over the last decade and evaluate associated feasibility, safety, and cost, relative to SAVR.

methodsWe identified adult and pediatric patients undergoing elective aortic valve replacement within the 2010-2022 Nationwide Readmissions Database. Ross and SAVR patients were age-matched using coarsened exact matching. Subsequently, multivariable regression was used to compare clinical outcomes, 30-day readmissions, and resource utilization between groups. The primary endpoint was a composite of in-hospital mortality, stroke, prolonged mechanical ventilation, reoperation, acute kidney injury, sepsis, cardiac arrest, and venous thromboembolism.

resultsAmong 109,235 valve replacements, Ross procedures constituted 1.5% of adult and 37.2% of pediatric cases. Utilization increased significantly over time across age groups (P < 0.001). Compared to SAVR, Ross recipients were younger, with fewer comorbidities, and often treated at high-volume teaching hospitals. After age-matching and risk adjustment, the Ross approach was associated with lower odds of composite complications (adjusted OR: 0.65; 95% CI: 0.46-0.91), particularly stroke (adjusted OR: 0.38; 95% CI: 0.18-0.80), as well as lower nonhome discharge and 30-day readmissions. Hospitalization costs were not significantly different between groups.

conclusionsThe Ross procedure is undergoing a resurgence in pediatric and adult populations, with favorable short-term outcomes and comparable costs to SAVR. These findings support broader adoption of the Ross operation at experienced centers for appropriately selected patients.

Indexed as

aortic valve diseaseaortic valve replacementcongenital heart diseaseNationwide Readmissions DatabaseoutcomesRoss operation

Identifiers

PMID41609284
PMCPMC12869883

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