Infective endocarditis after the Ross procedure.

The Ross procedure is presumed to have a lower incidence of infective endocarditis during follow-up compared to other traditional aortic replacement procedure. We describe 4 cases of infective endocarditis during follow-up of 96 patients who underwent the Ross procedure in our institution. All episodes occurred in patients with a previously dysfunctioning graft. One patient required surgery during the active phase of the infective endocarditis. Clinical outcome was successful in all patients and no one died during follow-up. In conclusion, the incidence of infective endocarditis in patients operated on using the Ross procedure is not negligible. The potential beneficial effect of the Ross procedure with respect to a higher resistance to infection should be evaluated in large prospective series.