Ross Procedure

The Ross procedure is intended to treat patients under age 60 who have a bicuspid aortic valve or tricuspid aortic valve with aortic stenosis or aortic insufficiency. This procedure can also benefit people with aortic valve endocarditis or other types of aortic valve disease. In the Ross procedure, surgeons use the patient’s own pulmonary valve instead of a mechanical or bioprosthetic artificial valve. This way, there is no risk of complications with artificial valves, including infective endocarditis (infection of the valve), no need to use a blood thinner (Coumadin) or require a second operation because of artificial valve degeneration.

Unfortunately, the Ross procedure is not an option for patients who have:

• Autoimmune disease
• Connective tissue disorders
• Coronary artery disease affecting three or more arteries
• Pulmonary valve disease

The Ross procedure can last for several hours. You will be under general anesthesia for the entire surgery, so you won’t feel or remember anything. At the start of your surgery, our surgeons will connect you to a cardiopulmonary (heart-lung) machine. This device safely takes control of your breathing and heartbeat.

After making a small incision (cut) in your chest, our experts open your breastbone so they can reach your aortic and pulmonary valves. Once they determine your pulmonary valve is healthy, they remove your aortic valve and replace it with your pulmonary valve. Next, they implant a healthy donor valve to replace your pulmonary valve.

When your replacement is complete, our surgeons will make sure your new valves are working properly. Then, they will disconnect you from the cardiopulmonary machine and close your incision.

The Ross procedure improves your blood flow and makes it easier for you to enjoy your daily activities, but it’s a complex surgery, so it presents some risks. These complications can include:

• Aortic autograft dilation (abnormal widening of the aorta around the new valve)
• Arrhythmia
• Heart attack
• Heart valve leakage
• Hemorrhage
• Infection
• Pulmonary allograft stenosis (narrowing of the new valve)

You may spend several days in the cardiac intensive care unit (ICU) after your surgery. During this time, we use a heart monitor to track your heart function. And you may need a ventilator to make it easier for you to breathe.

You will continue to recover for several months after you leave the hospital. As you improve, it’s normal to experience:

• Appetite loss
• Constipation
• Depression
• Fatigue
• Insomnia
• Numbness or swelling near your incision
• Shortness of breath

You may need a new replacement pulmonary valve within 15 to 20 years. Regular checkups to monitor your condition are important so we know when it’s time to replace your valve.

Call your doctor immediately if you experience these symptoms after the Ross procedure:

• Bright red stool (poop)
• Chest pain
• Chills
• Coughing up blood
• Dizziness
• Fever
• Tingling in your hands or feet
• Unexplained or unusual bruising or bleeding
• Vomiting