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Pulmonary Valve Replacements For The Ross Procedure

Written By: Adam Pick, Patient Advocate, Author & Website Founder
Page Last Updated: May 17, 2026

In a recent email to me, Jerry asked one of the most interesting questions about the Ross Procedure. As you can read below, Jerry inquired about the surgical process IF the patient's pulmonary valve is not qualified for transplant to the aortic position. To learn more about the Ross operation, click here.

Jerry writes:

Hi Adam,

I'm scheduled for a Ross Procedure in a couple of days. I've been nicely in denial about the whole thing, but I did have a question about "pulmonary spares". My brother brought it up last night.

Going into the operating room, what sort of spare valve replacements will the surgeon have with him? I would gather that the replacement valve for the pulmonary has been tested, but what if, even after the MRI and angiogram, the surgeon decides the pulmonary valve cannot be reused?

Thanks, Jerry

HERE IS MY RESPONSE TO JERRY ABOUT SPARE PULMONARY VALVES AND THE ROSS:

Jerry,

I had the exact same question for my surgeon before my aortic valve replacement.

"What if my pulmonary doesn't fit? Or, what if the valve is also diseased?" I asked Doctor Starnes.

"It's a game time decision," Dr. Starnes replied.

If the pulmonary valve doesn't pass the water / size test, the Ross Procedure won't be for you. In that case, your surgeon will have a back-up plan with an alternative replacement valve - either mechanical or bioprosthetic given your health, preferences and risk factors. My thoughts and prayers are with you as you head into surgery. Please keep me updated.

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

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