After I was diagnosed with severe aortic stenosis and regurgitation, I chose the Ross Procedure for my heart valve replacement surgery. While this approach to aortic valve replacement is more complex, I found the benefits of this procedure outweighed the risks.

Since launching this website, I have become familiar with a handful of surgeons who are considered Ross Procedure gurus. In particular, Dr. Paul Stelzer, from Mount Sinai Medical Center in New York, is widely regarded as one of the most experienced Ross Procedure surgeons in the United States.

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Since having my aortic valve replaced via the Ross Procedure in 2005, I’ve received a number of questions about this unique double heart valve replacement. One of the most common questions is, “Isn’t that operation more risky as two valves are replaced?”

I have to admit, that is a very fair question. I remember thinking the same thing when both Dr. Trento and Dr. Starnes suggested this relatively uncommon surgical approach. However, as I did my research on the Ross Procedure, the benefits started to outweigh the risks.

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I just received an interesting question from Greg about the Ross Procedure option for aortic valve replacement.

Greg writes, “Adam – I’ve been diagnosed with severe aortic stenosis. According to my cardiologist, I’ll be needing surgery in the next few months. Thanks to you, I now know about the Ross Procedure. It seems like it could be a good option for me as I’m active and do not want to be on Coumadin for the rest of my life. However, unlike you, I’m a bit older at 57 years of age. I’m wondering if I’m too old for the Ross Procedure? Do you have any thoughts? Thanks for all you do! Greg”

Since I did not have an immediate answer for Greg, I immediately conducted some research which relied upon Dr. Paul Stelzer’s 20-year experience with the Ross Procedure.

As you may know Dr. Stelzer has performed over 400 Ross Procedures during his career. If you are interested, here is video of Dr. Stelzer performing this complex double heart valve replacement.

Dr. Paul Stelzer – Mount Sinai Hospital (New York)

In response to Greg’s question, Dr. Stelzer offers the following:

• Age is not just a number but a physiologic state. Because the Ross Procedure is designed to be a long term solution for aortic valve disease (e.g. aortic stenosis), it is suitable for anyone with at least a 25 year life expectancy.
• Usually that translates into someone less than 65, but a few older patients have had this operation quite successfully.
• For older patients, simpler alternatives of aortic valve replacement offer 15-20 year durability and are widely available.

Considering Dr. Stelzer’s comments, it appears that Greg may be a candidate for the Ross Procedure. However, I would encourage Greg (and perhaps you) to discuss this and other surgical procedures with your medical team prior to making any conclusions about the best treatment method.

I hope this helped you learn more about the Ross Procedure and Dr. Paul Stelzer.

Keep on tickin!

If you ever wanted to learn more about the Ross Procedure, this is the place to do it. The second-annual Ross Procedure Summit kicks off in Atlanta today. Here are the details:

Elite cardiovascular surgeons from around the world will travel to suburban Atlanta this week for the two-day Ross Procedure Summit to review and discuss current peer-reviewed data relating to the survival advantage of the Ross Procedure and to practice the technical nuances required to perform this heart surgery successfully.

The Ross Procedure is a type of specialized aortic valve surgery in which the patient’s diseased aortic valve is replaced with his or her own pulmonary valve. The pulmonary valve can then be replaced with a cryopreserved human pulmonary valve.

Nine peer-reviewed articles regarding the Ross Procedure representing individual series from eight different countries, comprising a total of 2,234 patients have appeared in major medical journals over the past four years and report that:

• The Ross Procedure is associated with excellent long-term survival;
• Late survival with the Ross Procedure is comparable to that of the age-matched general population; and
• There is an excellent propensity-adjusted survival with the Ross Procedure in a pediatric patient population study compared to the excess mortality demonstrated with using a mechanical valve (as reported by one of the nine reports).

Led by Professor Sir Magdi Yacoub, FRS, FRCS, of Imperial College’s Heart Science Center in London in tandem with William F. Northrup III, MD, vice president of physician relations and education at CryoLife, the Ross Summit will have a faculty of more than 30 world-renowned cardiovascular surgeons and cardiologists, who will present clinical data on heart reconstruction surgery at their respective clinics.

The Ross Procedure is performed on up to 1,500 individuals globally each year — a number that is expected to increase as survival data become more widely known.

“In children, young adults and in active older adults, the Ross Procedure offers several advantages over other traditional aortic valve replacement options,” said Dr. Northrup. “The most important advantage is growing evidence of improved long-term survival over other valve replacement options. The procedure is also attractive because patients do not have to take long-term, blood-thinning medications after surgery as they would with mechanical valves. This is particularly appealing to women of child-bearing age, athletes and active adults.”

Dr. Vaughn Starnes – My Ross Procedure Surgeon

“The Ross Procedure requires very specific surgical expertise to achieve predictable, long-lasting results, and The Ross Summit was created to foster data exchange to provide a well-rounded point of view in addition to offering critical procedural training,” noted Steven G. Anderson, chairman, president and CEO of CryoLife.

A live webcast of the Ross Summit can be viewed at http://www.TheRossCommunity.org.

As many of you know, Dr. Vaughn Starnes performed the Ross Procedure on me several years ago. If you have any questions or would like to learn more about the Ross Procedure, feel free to email me.

Keep on tickin!

Linda just sent me an email about one of the surgical options for aortic valve replacement, known as the Ross Procedure or “Switch” procedure.

She writes, “Hi Adam – I was curious what your surgeon told you about how long the Ross Procedure would last. My doctor said it would last the rest of my life.  But, during my yearly echos (and other testing), we have detected severe leakage of the aortic valve and moderate-to-severe leakage with my pulmonary valve.  I had to have both valves replaced in March of this year. I had the Ross Procedure 15 years ago.  I’m curious to find out your experience and others. Thanks, Linda”.

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