Ross procedure as a viable alternative to tissue and mechanical AVR?
JAAC brings new light to this. See this recent comparison of the survival rates...
http://www.onlinejacc.org/content/71/12/1337
Adela Morsz Hi Rune,
In Europe Prof. Hans-Joachim Schäfers (Homburg, Germany) is very experienced surgeon in BAV ... Read more
Adela Morsz Hi Rune,
In Europe Prof. Hans-Joachim Schäfers (Homburg, Germany) is very experienced surgeon in BAV repair (probably also in calcified BAV).
Rune Pedersen Dear Adela, the only scientific study behind Edwards' newly FDA approved valve, I've found so far is ... Read more
Rune Pedersen Dear Adela, the only scientific study behind Edwards' newly FDA approved valve, I've found so far is quite small (31 patients), but more for sure will follow in coming years.
Most surgeons are conservative with their valve choices until they see large studies continuously pointing in the same direction.
One top surgeon from a very respected and credible US hospital shared this with me about the new Inspiris Resilia:
"Improved durability is yet to be proven, as is any advantage versus other tissue valves as a platform for future TAVR. Valve in valve and need for anticoagulation are also yet to be proven, plus valve in valve is a lot of hardware in the root and compromised access to the coronary ostea. We use Edwards, but we actually still believe their 2700 valve is the best, better than any of the newer they market. Among mechanical valves we use On-X and St Jude and they are both excellent, On-X being my favorite."
I'm personally leaning towards a Ross procedure rather than a biological or mechanical aorta valve.
It's superior on nearly all counts (no blood thinners, no clicking noise, no stroke risk, longer durability than tissue valves, lower risk for re-operation than tissue valves, and lover infection risks than both tissue and mechanical valves.
There's a fair chance of having 30-40 good years with few complications from the Ross procedure - roughly 2/3 pass their 20th anniversary with no complications or re-ops!).
However to be eligible you'll have to fulfil (at least) six criteria:
1) Age under 50ish;
2) a healthy heart (apart from the AS);
3) AV root annulus smaller than 30mm,
4) cusps on the pulmonary valve not too thin and not calcified;
5) geometri and dimensions must match with the AV it's to replace;
6) and the ascending aorta must not be too enlarged (under 45mm).
If you match that, your should seriously consider a Ross.
However make sure the surgeon has at least 200ish Ross procedures on the counter, and compare their outcomes.
Adela Morsz Dear Rune,
Thank you so much for taking the time to share your knowledge.
I have found some informati ... Read more
Adela Morsz Dear Rune,
Thank you so much for taking the time to share your knowledge.
I have found some information about Ross techniques:
http://www.uphs.upenn.edu/surgery/avr/presentations/2016_Day_2/2N_Sievers_Ross_Procedure.pdf
Rune Pedersen Yes, this presentation is cool! Watch also the video I have linked to in my journal. Gives a totally ... Read more
Rune Pedersen Yes, this presentation is cool! Watch also the video I have linked to in my journal. Gives a totally new perspective on Ross, and documents some really good outcomes in Europe with this. Exciting.
Adela Morsz Dear Rune, Thank you for a worthly video.
Please keep us posted.
A very interesting overview of the Ross procedure vs. tissue valves in terms of freedom of re-ops. See my journal for more.
Roger Perkins Rune - Briefly, at age 48 I had a tissue mitral valve replacement in Oct. 2015. One year later the v ... Read more
Roger Perkins Rune - Briefly, at age 48 I had a tissue mitral valve replacement in Oct. 2015. One year later the valve failed and I had an On-X mitral installed. I had absolutely no choice in the 2nd OHS than to go w. mechanical. I am now 11 months out from my last OHS.
There is a slight learning curve to the warfarin, but, so far it has not been a huge deal. I too am active in working out approx. 4 days/week. If you care to inquire further about any specifics my email: rperkins238@gmail.com
What is your opinion about: https://www.edwards.com/eu/_layouts/Edwards.moss.web.webapp/resi ... Read more
What is your opinion about: https://www.edwards.com/eu/_layouts/Edwards.moss.web.webapp/resilia-eu/?WT.ac=INSPIRISRESILIAAorticValve
In Europe Prof. Hans-Joachim Schäfers (Homburg, Germany) is very experienced surgeon in BAV ... Read more
In Europe Prof. Hans-Joachim Schäfers (Homburg, Germany) is very experienced surgeon in BAV repair (probably also in calcified BAV).
Most surgeons are conservative with their valve choices until they see large studies continuously pointing in the same direction.
One top surgeon from a very respected and credible US hospital shared this with me about the new Inspiris Resilia:
"Improved durability is yet to be proven, as is any advantage versus other tissue valves as a platform for future TAVR. Valve in valve and need for anticoagulation are also yet to be proven, plus valve in valve is a lot of hardware in the root and compromised access to the coronary ostea. We use Edwards, but we actually still believe their 2700 valve is the best, better than any of the newer they market. Among mechanical valves we use On-X and St Jude and they are both excellent, On-X being my favorite."
I'm personally leaning towards a Ross procedure rather than a biological or mechanical aorta valve.
It's superior on nearly all counts (no blood thinners, no clicking noise, no stroke risk, longer durability than tissue valves, lower risk for re-operation than tissue valves, and lover infection risks than both tissue and mechanical valves.
There's a fair chance of having 30-40 good years with few complications from the Ross procedure - roughly 2/3 pass their 20th anniversary with no complications or re-ops!).
However to be eligible you'll have to fulfil (at least) six criteria:
1) Age under 50ish;
2) a healthy heart (apart from the AS);
3) AV root annulus smaller than 30mm,
4) cusps on the pulmonary valve not too thin and not calcified;
5) geometri and dimensions must match with the AV it's to replace;
6) and the ascending aorta must not be too enlarged (under 45mm).
If you match that, your should seriously consider a Ross.
However make sure the surgeon has at least 200ish Ross procedures on the counter, and compare their outcomes.
Thank you so much for taking the time to share your knowledge.
I have found some informati ... Read more
Thank you so much for taking the time to share your knowledge.
I have found some information about Ross techniques:
http://www.uphs.upenn.edu/surgery/avr/presentations/2016_Day_2/2N_Sievers_Ross_Procedure.pdf
Please keep us posted.