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Department of Surgery Referrals Patient Clinician Researcher

Procedures & Innovations Ross Procedure

What is the Ross Procedure?

Aortic valve failure due to stenosis (narrowing) or aortic incompetence (leaking) may be caused by congenital birth defects or certain illnesses and diseases. The Ross procedure is a surgical option for treating aortic valve failure. In the Ross procedure, the diseased aortic valve is removed and replaced with the patient's own pulmonary valve (autograft). After the pulmonary valve is transferred to the aortic position, a donor pulmonary homograft (human cadaver) valve is sewn into the pulmonary position, and the coronary arteries are reimplanted.

The Ross procedure is particularly appropriate for children and young adults with diseased aortic valves. The pulmonary valve is a good match in size to the aortic valve, it has the potential to grow as the child grows (which artificial valves cannot do), and it is well suited to the high pressures in the aorta. The procedure is also a good option for women who wish to become pregnant and for active patients who do not wish to take anticoagulants.

Surgical Experience

Studies have shown that the Ross procedure can provide excellent long-term function. Only 10 to 15% of patients have required reoperation due to deterioration of the replaced aortic valve after 10 to 15 years. Columbia University Medical Center is one of the leading institutions performing this procedure. Dr. Jan Quaegebeur has completed over 150 Ross procedures in adults worldwide. None of these patients has required reoperation.

Advantages of the Ross Procedure

  • Anticoagulation medications are not needed
  • Thromboembolic complications are reduced
  • Risk of endocarditis is reduced
  • The natural valve is superior to prosthetic or bioprosthetic valves
  • The autograft can grow with the heart
  • Patients' activities do not need to be limited

Disadvantages of the Ross Procedure

  • The operation requires special expertise
  • In a small percentage of patients, replacement of the pulmonary valve may be required later

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