Ross Procedure Risks For Aortic Valve Replacement Addressed By 16 Year Study
When I share my Ross Procedure experience with patients suffering from aortic valve disease, I typically receive a very appropriate, knee-jerk response. That response goes like this, “What? Huh? Ya mean… Umm… You had two valve replacements, not just one… Isn’t that more risky?”
As I have explained before, the answer to that question is both “yes” and “no”. (To read more about my thoughts on the Ross Procedure, please click here - “Why I Chose The Ross Procedure For Aortic Valve Replacement?“)
Even though my Ross Procedure was several years ago, I continue to evaluate this complex operation as part of my ongoing research specific to heart valve surgery. This morning, I read a new study at CardiSource titled, “Ross Procedure: A Sixteen Year Experience”.
Aortic And Pulmonary Valve Replacement
In this unique study, 487 Ross Procedure patients who underwent the operation between 1986 and 2002 were evaluated. The Ross operation was offered to all children, young adults with isolated valve disease, and older adults with an active lifestyle and a desire to avoid anticoagulation.
As for the types of patients that were observed in this study:
- The median age of the patient was 24 years and the majority of patients included children ages 1 day to 18 years and young adults ages 18-50 years.
- The predominant aortic valve disease was combined aortic regurgitation and aortic stenosis comprising 49% of patients. Other patients had isolated cases of stenosis, regurgitation and endocarditis.
Ultimately, the key finding of the study was specific to survival rates for those who had the Ross Procedure. According to this study, led by Dr. Ronald Elkins, the survival rates of the Ross Procedure were very good.
Approximately, 89% of patients were still living 16 years after their Ross Procedure. And, there were no late deaths identified with autograft valve or allograft valve reoperation. When matched with survival of the general US population matched by each patient’s age, sex, and year of operation, after the initial decrease associated with early mortality, the survival curve parallels the survival of the matched United States population.
However, as I’ve stressed before, this is a very complex operation. That said, please conduct an incredible amount of surgeon research and due diligence before having this, or any, operation. Some of the most widely used Ross Procedure surgeons I know of are: Dr. Vaughn Starnes, Dr. Paul Stelzer, Dr. William Ryan, Dr. Ronald Elkins and Dr. John Oswalt.
I hope that helps explain a little more about this risks and results of the Ross Procedure.
Keep on tickin!
About The Author: Adam Pick is a double, heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery, a unique book which integrates the clinical facts of heart valve surgery with the personal experiences of 78 former valve surgery patients. To learn more about Adam and his heart valve surgery book, click here.
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December 8th, 2008 at 3:41 pm
Is there any information on pleural effusion as a complication from aortic replacement. I am having to be tapped fo the third time since my surgery on Oct 30th.
December 8th, 2008 at 3:53 pm
young adults ages 18-50 years.
I’ve read this phrase several times now to enjoy being called a young adult.
December 8th, 2008 at 5:07 pm
Adam,
Didn’t Dr. Elkins retire from surgery? Had heard that he turned that over to another surgeon…possibly his son?
December 9th, 2008 at 9:48 pm
Adam,
It seems that you know a lot about the Ross procedure. I has an aortic valve replacement 2 years ago. Scar tissue has grown under the valve and I have worse stenosis than before. The annulus is also very small and they would have to go in and work with that.
From My reading, it seems as if the Ross procedure might be one of the options.I had Dr. Cohen out of USC. He said that the had never gone in to take out a mechanical valve before and that he wouldnt look forward to it. ( A huge red flag went up.)
I have been looking into Cedar Sinai as an alternative option. I would also like to have an opinion by Dr.Starnes. Any links that you have would be greatly appreciated.
LAurie Collins
(Dr. Cohen and Dr. Starnes work together down at Children’s Hospital.)
December 16th, 2008 at 10:38 pm
Janet, I had a thorensentisis (sp) and drained 800 cc from my right lung. I found out later that it was very common to have this after surgery. It was later determined from an echo that I had a leaky tricuspid valve. I am sure you probably have had an echo and you might want to look at what the results are. My tricuspid is still leaking substantially 4 weeks post op and I will probably be on diuretics forever trying to control the fluid. The doctors indicate that this is not life threatening. What lung are you having drained? If it is the right one - it may indicate the tricuspid leaking?? Good luck.