Ross Procedure Statistics - Success, Failure & Reoperations

By Adam Pick, Patient & Author of The Patient's Guide to Heart Valve Surgery

Surgical outcomes specific to the Ross Procedure, its success rates, failure rates and repoperations

When I was formally diagnosed with severe heart valve disease (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 vales) and mechanical valve replacements.

Then, I learned about the advantages of a special form of aortic valve replacement surgery known as the Ross Procedure Surgery. I immediately became very interested in the possibility of having my pulmonary valve switched to my aortic position.

So you know, The Cleveland Clinic refers to the Ross Procedure as the "Switch Procedure" because the patient's pulmonary valve is removed and literally 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 anti-coagulants for the rest of my life. (This is required for 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 complication specific to tissue rejection of pig valves or cow valves.

Clinical Research Results Of The Ross Procedure

Still, I wanted to know more about the success, failure and reoperation rates of the Ross Procedure. That said, I conducted alot of clinical and patient research to better understand whether or not the Ross Procedure would be suitable for me.

Overall, I learned that the long-term statistics of the Ross Procedure were encouraging - although the surgical outcome for the Ross Procedure can be confusing depending on who is reporting the results.

Without going into all the data I located, there are some well documented Ross Procedure statistics:

• Overall, 85% to 90% freedom from reoperation at 10 years.
• Approximately 75% to 80% freedom from reoperation at 20 years.

In fact, data from Donald Ross, the inventor of the Ross Procedure who first performed the surgery in 1967, showed freedom from re-operation at 75% twenty-five years after surgery. Bear in mind that much of this data was developed before homograft-wrapping techniques were implemented.

Dr. John Oswalt from Austin, Texas reports that his Ross Procedure patients are 92% free from reoperation seventeen years after surgery. Dr. Paul Stelzer from New York has reported similar success after four hundred and twenty Ross Procedure surgeries.

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 475 Ross Procedures since 1987. 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 my Ross Procedure 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.

> Next: To learn about the Ross Procedure Surgery for aortic valve replacement, please click here.