Two Great Questions About The Ross Procedure… From Duane

I give A LOT of credit to patients and caregivers that really, really, really, really do their homework prior to heart valve replacement or heart valve repair surgery. I can immediately tell from the questions you ask me just how diligent you’re being at each phase of the surgical process.

Case in point… Duane Schlosser (55 years of age) from Austin, Texas just sent me two interesting questions about the Ross Procedure and minimally invasive pulmonary valve replacements that I thought you might benefit from. That said, here is what Duane writes:

Duane Schlosser – Heart Valve Replacement Patient


Thank you for your heart valve surgery book. It has helped me come to grips with my own situation. I am scheduled for aortic valve replacement in September via the Ross Procedure. I have a two-part question for you.

  • In the Ross procedure, a donor valve is use to replace the pulmonary valve. Over time, lets say 15+ years, which valve is subject to fail first? The donor valve or the pulmonary valve which is in the aortic valve position?
  • The second part question is this… With the advent of the “non-invasive” procedure to replace the aortic valve being done in Europe, do you know if this procedure can be done to replace the pulmonary valve if it failing due to a previous Ross Procedure? Forward thinking, I will need to consider a second replacement if the donor valve fails and if the non-invasive procedure will apply to the pulmonary valve.

Thanks! Duane



Nice to meet you and thanks for sharing your story with me. You raise some great questions about the double heart valve replacement procedure, known as the Ross Procedure. As you may know, I had a Ross Procedure performed on me several years ago by Dr. Vaughn Starnes at USC Medical Center.

Diagram Of The Ross Procedure (aka “Switch Procedure”)

To answer your first question, here is a link that provides some statistical data on the success rates of the Ross Procedure and the failure rates of autografts (the switched valve) and homografts (the donor valves):

As shown in Dr. Raines’ clinical study, it appears that – due to the lower pressures of the pulmonary valve position – the autograft is more susceptible to failure. At the time I collected this data, Dr. Raines had yet to have a homograft fail.

Now, as for your second question… Yes, I am very hopeful that minimally invasive procedures (especially transcatheter approaches) will be approved for pulmonary valve replacements in the future here in the United States.

SAPIEN Valve Replacement System

In fact, if you research the SAPIEN heart valve replacement system, offered by Edwards LifeSciences, you will see that this unique technology is currently in trials for minimally invasive pulmonary valve replacements.

I hope that helps Duane (and perhaps you) better understand the Ross Procedure and minimally invasive pulmonary valve replacements! Thank to Duane for your questions!

Keep on tickin!

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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