Ross Procedure

There are many considerations in choosing the type of valve for aortic valve replacement, and each patient will ultimately need to discuss the type of valve with a cardiac surgeon. Your physician may choose to use the Ross Procedure for aortic valve replacement. In the Ross Procedure, the surgeon removes the patients' diseased aortic valve and replaces it with his or her own pulmonic valve. The pulmonic valve is then replaced with a homograft valve, which is a valve from another human donor.

The importance of the Ross Procedure is that the patients' own valve is used in the crucial aortic position. The aortic valve connects the heart to the rest of the body, and has the highest pressure and blood flow of any valve.

The are two main advantages to the Ross Procedure. First, there is a longer life associated with the patients' own pulmonic valve in the aortic position versus a bioprostheses. This is important in young, active people because they can maintain an active lifestyle. Second, the pateint will not need to remain on anticoagulation medications (Coumadin) permanently. This is important, for example, in a woman of childbearing years because anticoagulants are contraindicated with pregnancy.

The Ross Procedure in Aortic Valve Replacement Surgery

The aortic valve is located between the powerful left ventricle and the aorta, which connects the blood pumped from the heart to the rest of the body. (For more information, please see our overview on the aortic valve). The aortic valve is crucial in maintaining flow of blood from the heart to the rest of the body. Although the mitral valve can often be repaired, the aortic valve is usually replaced when there is disease because of the high pressure and volume through the aortic valve. To determine if there are options for aortic valve sparing techniques, please contact a cardiac surgeon at (949) 650-3350.

The Ross Procedure

In the Ross Procedure, the patient is put to sleep with general anesthesia and an anesthesiologist monitors consciousness throughout the operation. Once the patient is asleep, the surgeon makes an incision down the middle of the chest and separates the breastbone. The patient is placed on the heart-lung machine to do the work of breathing and pumping oxygenated blood for the patient.

The surgeon will then access the heart and carefully remove the damaged valve. The diseased valve is discarded and the patients' own pulmonic valve is sutured in its' place. The surgeon will then place a homograft valve (a valve from a human donor that has been removed, treated with antibiotics, and frozen for preservation) in the pulmonic position. After the valves have been replaced, the surgeon will close the heart and sternum.

After surgery, the patient will be taken off the heart-lung machine and moved to the CVICU (Cardiovascular Intensive Care Unit) where specialized staff will closely monitor the patient.

Risks of Surgery

Open-heart surgery is considered a major surgical operation and as such is associated with the following risks: stroke, heart attack, bleeding, infection, nerve damage, breathing problems, drug reactions, blood reactions, arrhythmias and death. Your surgeon will discuss these and other risks with you before your operation.

Patient Stories

Ross Procedure Patient Success Story

Other Information on Aortic Valve Replacement

AMC - Ross Procedure Information
CTVS - The Ross Procedure
CTSNet - Ross Procedure