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SPEAKER: The Ross procedure for the treatment of aortic valve disease. The Ross procedure is an alternative to traditional aortic valve replacement surgery that may better meet the needs of a younger patient. In this population, the Ross procedure is associated with better long-term outcomes in selected patients compared to conventional AVR. Additionally, the patient can achieve an excellent quality of life while maintaining an active lifestyle, without the lifelong need for blood thinners.
The heart is a muscular organ that pumps blood throughout the body. Within the heart are four valves. Each of these valves have cusps or flaps that open and close during each heartbeat in order to maintain blood flowing in one direction through the heart. Aortic valve stenosis is a disease that obstructs blood flow into the aorta, making it difficult for the heart to pump blood into the aorta, and onward to the rest of the body. This causes the heart to work harder, and can lead to heart failure and other associated problems.
During the Ross procedure, the patient's diseased aortic valve is removed, and the coronary arteries, which are the heart's blood supply, are moved. The patient's own living pulmonary valve is then harvested, and is reinforced if growth is complete, and transferred into the aortic position to function as a new aortic valve. This is known as an autograft, since the patient's own pulmonary valve is used.
To replace the harvested pulmonary valve, a pulmonary homograft, which is a human donor valve, is placed into the position where the original pulmonary valve came from. The Ross procedure is the only AVR operation that allows replacement of the diseased aortic valve with a living substitute. This living valve is more durable, and can grow with the patient. These benefits translate into low rates of valve-related complications, and an excellent long-term survival.
However, some patients will require future interventions on either valve. For these reasons, when treating a younger patient with aortic valve disease, the Ross procedure, despite its inherent complexity, should remain a primary surgical consideration. The Ross procedure should be performed by an experienced team at a center of excellence that meets very high standards. As a dedicated center with experienced surgical and multidisciplinary teams and aftercare, Mayo Clinic is able to consistently provide excellent outcomes, and maintain communication with the home medical team.
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