Ross Procedure Surgery
When I was formally diagnosed with severe heart valve disease (aortic stenosis), I learned that my aortic valve needed to be replaced quickly. Shortly therefter, I spent a tremendous amount of time evaluating my surgical options and the different types of valve replacment devices. I considered porcine valves (pig valves), bovine valves (cow valves), homografts (human donor valves) and mechanical valve replacements. Then, I learned about the advantages of a special form of aortic valve replacement surgery known as the Ross Procedure.
If you were unaware, The Cleveland Clinic refers to the Ross Procedure as the "Switch Procedure" because the patient's pulmonary valve is removed and switched to the aortic position. Then, a homograft (a human donor valve) is placed in the pulmonary position.
There are several benefits of the Ross Procedure for the patient. Specifically, I liked the fact that I would not need to use anticoagulants (e.g. Coumadin) for the rest of my life. This is required for patients who select mechanical valve replacement devices.
Also, another benefit of the Ross Procedure is the fact that I would stil have my own pulmonary valve in the aortic position following the operation. My research suggested this would reduce any form of post-operative complications specific to tissue rejection of pig valves or cow valves.
Ross Procedure Surgical Results
Still, I wanted to know more about the success, failure and reoperation rates of the Ross Procedure. That said, I conducted significant clinical and patient research to better understand whether or not this special form of aortic valve replacement would be suitable for me.
Overall, I learned that the long-term statistics of this double heart valve replacement surgery was very encouraging. Without going into all the data I coillected, here is some data for you to consider:
- Overall, 85% to 90% freedom from reoperation at 10 years.
- Approximately 75% to 80% freedom from reoperation at 20 years.
In fact, data from Dr. Donald Ross, the inventor of this technique (who first performed the surgery in 1967), showed freedom from re-operation at 75 percent twenty-five years after surgery. Also, we need to remember that much of this data was developed before 'homograft-wrapping' techniques were implemented.
Other clinical results from other surgeons include:
- Dr. John Oswalt from Austin, Texas reports that his patients are 92% free from reoperation seventeen years after surgery.
- Dr. Ed Raines, in Lincoln, Nebraska has had to redo 3% of Ross Procedure surgeries during the past ten years due to dilation of the root (prior to wrapping). Plus, Dr. Raines has not had a homograft fail yet.
Recently, I met with Dr. Paul Stelzer, of Mount Sinai Hospital in New York. Dr. Stelzer has performed over 500 Ross Procedures since 1987. Dr. Stelzer’s clinical results suggest that less than 10% of patients require re-operation up to 10 years after surgery.
My Patient Experience With The Ross Procedure? I had my Ross Procedure performed on December 21, 2005 by Dr. Vaughn Starnes at the USC Medical Center in Los Angeles. So far, the Ross Procedure has worked out very well for me. Although the recovery from open heart surgery was not easy, the result from this heart valve surgery has been excellent.
However, please note... There are several "do's" and "dont's" when it comes to selecting the Ross Procedure for aortic valve replacement.
Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.