Using Beta Blockers After Heart Valve Replacement Via The Ross Procedure

One of the advantages of using the Ross Procedure is the fact that patients do not require the use of any medications (e.g. Coumadin) following the operation.

Recently, however, I learned from Lee Crowley that Dr. Ryan suggests that all Ross Procedure patients take beta blockers. My cardiothoracic surgeon, Dr. Vaughn Starnes, has a different opinion as I am not currently taking any medication. Yet, I found Lee’s email to be very interesting. Therefore, I thought I would post it for all you to consider. Here it is:

I am on 50 mg Toprol XL 2X/day. Dr. Ryan (William Ryan III) puts almost all of his Ross patients on a Beta Blocker, as I understand it. I actually called him a couple of weeks ago to see if I could reduce the dosage, and he recommended I not do that at this time.

He said the reason for the Beta Blocker is two-fold.

  • One, it keeps my BP in check. He said Ross patients need to keep their Systolic pressure below 120 (preferably around 110). My “normal” BP well before my surgery was around 135/80. Now, it is usually around 112/70.
  • Second, the Beta Blocker will reduce my heart rate, especially during activity. This is important to reduce the stress on the heart, especially while it goes through remodelling. I had significant LV Hypertrophy.

Dr. Ryan said he likes to keep his Ross patients on a Beta Blocker indefinitely most of the time. He strongly believes it will help the longevity of the valves. He said I will probably be able to reduce my dosage to 25mg 2X/day at 1-year post-op, and down to 25mg 1X/day one year after that.

I mentioned side effects in my previous post. One side effect I attribute to the Toprol XL is I feel a little sluggishness when I play tennis. I play at a pretty high level, and feel a “micro-second” slow when I play. That’s the best way I can describe it. I played tennis right up to my surgery and did not have this problem. Also, I am cold a lot more often than before, which is a known side effect.

I also occasionally have weird, vivid dreams that I did not have before. I actually enjoy this side effect. 🙂

These are not really significant in the grand scheme of things. I can definitely live with them.

I hope your recovery continues to go well. I really enjoyed your pictures of the surgery.


Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of

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