{"id":4986,"date":"2024-10-14T20:14:15","date_gmt":"2024-10-14T20:14:15","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=4986"},"modified":"2024-10-16T22:57:17","modified_gmt":"2024-10-16T22:57:17","slug":"4-ross-procedure-facts","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/4-ross-procedure-facts\/","title":{"rendered":"Surgeon Q&#038;A: 4 Must-Know Facts About The Ross Procedure"},"content":{"rendered":"<p>Medical advances in aortic valve disease treatment have given patients more options now than ever before. Unfortunately, it\u2019s not an easy, one-size-fits-all decision about which procedure to choose. There are aortic valve replacement options with a cow, pig and\/or mechanical valve. There are minimally-invasive transcatheter therapies. \u00a0Then, there are aortic valve reconstruction techniques including the Ozaki Procedure and\u2026 the Ross Procedure.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-4999 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/ross-procedure-scalpel-diagram.jpg\" alt=\"Ross Procedure Diagram with Scalpel\" width=\"500\" height=\"427\" \/>Ross Procedure<\/p>\n<p>&nbsp;<\/p>\n<p>Given recent durability research, the Ross Procedure is an advanced form of aortic valve reconstruction that has received significant interest from patients in our community. As you may know, I had the Ross Procedure performed in 2005 when I was 33 years old.\u00a0 Since then, I have not had one cardiac issue and I do not take any medication.<\/p>\n<p>To learn why so many patients and doctors are talking about the Ross Procedure, I connected with <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Ismail-El-Hamamsy-New+York+City-New%20York.php\">Dr. Ismail El-Hamamsy<\/a>, who is a world-renowned Ross Procedure surgeon at Mount Sinai Health in New York City, New York. During his extraordinary career, Dr. El-Hamamsy has performed over 800 Ross Procedures. That said, I was very excited to have this special conversation with Dr. El-Hamamsy and learn his \u201cTop 4 Facts\u201d that patients should know about the Ross procedure.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/eMpNQHyl__I?rel=0\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>4 Must-Know Facts About The Ross Procedure<\/h2>\n<p>Here are four important facts about the Ross Procedure as shared by Dr. Ismail El-Hamamsy:<\/p>\n<p>Fact 1: Is there any new data about patient outcomes for the Ross Procedure?<\/p>\n<ul>\n<li>Dr. El-Hamamsy explained that the Ross Procedure involves replacing the aortic valve with a patient\u2019s pulmonary valve, a mirror image of a normal aortic valve. \u201cIt\u2019s a living valve that remains alive over the long term,\u201d he said. \u201cJust a couple of months ago, we published a study in <a href=\"https:\/\/jamanetwork.com\/journals\/jamacardiology\/article-abstract\/2811496\">JAMA<\/a> where we looked at a cohort of patients who had undergone the Ross Procedure in the 90s. These were part of a randomized trial we published in 2010 in the <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(10)60828-8\/abstract\">Lancet<\/a>, and we decided to update their follow-up and report the outcomes. Now, into the third decade after the Ross Procedure, this is the longest published follow-up available in the literature. The average follow-up was 25 years, and remarkably, the survival of these patients continues to mirror that of the general population. That is truly unique within the field of valve surgery. There are no other operations so far that have been demonstrated to restore survival that far after the operation.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-5001 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/ross-procedure-survival-research.jpg\" alt=\"Ross Procedure Survival Research\" width=\"650\" height=\"365\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>Fact 2: Is there a renewed enthusiasm about the Ross Procedure?<\/p>\n<ul>\n<li>\u201cAbsolutely,\u201d Dr. El-Hamamsy said. \u201cOver the last five to seven years, there\u2019s been a true global \u2018Ross Procedure Renaissance,\u2019 including North America. It\u2019s all rooted in the evidence that\u2019s been published over the last 10 to 15 years showing the multiple benefits of a Ross Procedure versus a mechanical or biological aortic valve replacement, namely in terms of survival of the patient, quality of life, durability of the operation, and hemodynamics.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4994 size-full\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/ross-procedure-benefits-el-hamamsy.png\" alt=\"Ross Procedure Benefits\" width=\"650\" height=\"362\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Dr. El-Hamamsy said that when looking at The Society of Thoracic Surgeons database for North America, they saw more than an eight-fold increase in the volume of Ross Procedures performed over the last five to six years. That amount shows that over seven percent of patients in the United States under 60 are getting a Ross Procedure, as opposed to less than one percent of patients in that age range getting a Ross Procedure six or seven years ago.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-5002 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/ross-procedure-increase-aats.jpg\" alt=\"Ross Procedures Performed in the United States\" width=\"650\" height=\"367\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>Fact 3: What steps are being taken to manage this \u201cRoss Procedure Renaissance&#8221;?<\/p>\n<ul>\n<li>\u201cThat\u2019s a great question,\u201d said Dr. El-Hamamsy. \u201cI think the renewed enthusiasm for the Ross also has to be tempered against the potential risks associated with the operation. There is no doubt that the Ross is a more complex operation than a regular aortic valve replacement. For that reason, it is very important to emphasize the notion of Ross reference centers or centers of excellence for reconstructive aortic surgery, which includes the Ross Procedure. There is a clear volume-outcome relationship regarding complex cardiac surgery that has been well established, and recent data presented at the American Association for Thoracic Surgeons meeting last month in Toronto analyzed those North American volumes of the Ross and the outcomes. What they clearly demonstrated was a volume-outcome relationship. Low-volume centers had higher complications after the operation, and high-volume centers had lower rates of complications.<\/li>\n<li>Dr. El-Hamamsy stressed, \u201cThe idea of a Ross reference is not just a surgeon who does a lot of Ross Procedures. The idea is that the patient is in the middle of the story, but a whole team managing the patient ensures perfect outcomes after the operation. Remember, these are all young patients, and we have to be batting 1,000 when we do this. There is no room for any error. So, it takes dedicated anesthetists, nurses, perfusionists, intensivists, and all these people who have seen many of these operations and have a lot of muscle memory, a lot of pattern recognition, and know exactly what we need to be looking for and what we need to be doing to make these operations successful.\u201d Dr. El-Hamamsy added that the operations need to be safe in the short term, and in the long term, they need to be durable.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Fact 4: How has the enthusiasm for the Ross Procedure impacted Dr. El-Hamamsy&#8217;s practice?<\/p>\n<ul>\n<li>\u201cLast year alone, we did over 100 Ross Procedures,\u201d Dr. El-Hamamsy said. \u201cIt\u2019s quite a remarkable number, but more proudly, every one of these patients went home well and safe with a successful result. I\u2019m also excited that we\u2019ve recently analyzed the outcomes of 450 patients, and less than five percent of them needed re-intervention after Ross Procedures.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h1>Thanks Dr. El-Hamamsy and Mount Sinai!<\/h1>\n<p>On behalf of everyone in the HeartValveSurgery.com community, many thanks to <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Ismail-El-Hamamsy-New+York+City-New%20York.php\">Dr. Ismail El-Hamamsy<\/a>, for explaining the top four facts we need to know. And, thanks to Mount Sinai Health for its extraordinary care provided to heart valve patients!<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/ross-procedure-reseach-dr-ismail-el-hamamsy\/\">Patient Research Alert: Ross Procedure Survival Advantages &amp; More<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/ross-procedure\/\">Ross Procedure: 10+ Important Facts For Patients<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/videos\/ross-procedure-advantages\">Webinar: Ross Procedure Advantages with Dr. Stelzer and Dr. El-Hamamsy<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the deaf and hard of hearing members of our community, I have provided a written transcript of this interview with Dr. El-Hamamsy.<\/p>\n<p>References:<\/p>\n<ul>\n<li>El -Hamamsy Ismail, Toyoda N, Itagaki S, et al. Propensity-Matched Comparison of the Ross Procedure and Prosthetic Aortic Valve Replacement in Adults. <em>J Am Coll Cardiol<\/em>. 2022;79(8):805-815. doi:10.1016\/j.jacc.2021.11.057<\/li>\n<li>Notenboom ML, Melina G, Veen KM, et al. Long-Term Clinical and Echocardiographic Outcomes Following the Ross Procedure: A Post Hoc Analysis of a Randomized Clinical Trial. <em>JAMA Cardiol<\/em>. 2024;9(1):6-14. doi:10.1001\/jamacardio.2023.4090<\/li>\n<li>El-Hamamsy I, Eryigit Z, Stevens LM, et al. Long-term outcomes after autograft versus homograft aortic root replacement in adults with aortic valve disease: a randomised controlled trial. <em>The Lancet<\/em>. 2010;376(9740):524-531. doi:10.1016\/S0140-6736(10)60828-8<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[16],"class_list":["post-4986","page","type-page","status-publish","hentry","category-ross-procedure"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/4986","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=4986"}],"version-history":[{"count":16,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/4986\/revisions"}],"predecessor-version":[{"id":5012,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/4986\/revisions\/5012"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=4986"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=4986"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}