{"id":5500,"date":"2025-04-21T20:48:38","date_gmt":"2025-04-21T20:48:38","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=5500"},"modified":"2025-07-29T18:28:35","modified_gmt":"2025-07-29T18:28:35","slug":"reverse-ross-procedure","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/reverse-ross-procedure\/","title":{"rendered":"The Reverse Ross Procedure: What Should Patients Know?"},"content":{"rendered":"<p>The <a href=\"https:\/\/www.heart-valve-surgery.com\/ross-procedure-aortic-disease\">Ross Procedure<\/a> is a complex aortic valve replacement operation that offers children and young adults a long-term solution to aortic stenosis and aortic. When the Ross Procedure is successful, patients can have the same quality of life as those without aortic valve disease with no restrictions on activity after recovery. The Ross Procedure involves removing the diseased aortic valve and replacing it with the patient\u2019s own pulmonary valve, called an autograft. A human donor valve, pig valve or cow valve replaces the pulmonary valve.<\/p>\n<p>Unlike mechanical valves that are prone to blood clots or biologic valves that may need to be replaced within ten years, the Ross Procedure is less likely to have these complications. Still, there is potential for durability issues with the Ross Procedure due to the high pressure the autograft is under in the aortic position. When a patient&#8217;s aortic valve autograft is compromised, one option is to undergo a Reverse Ross Procedure.<\/p>\n<p>Adam Pick, the founder of HeartValveSurgery.com, had a Ross Procedure nearly 20 years ago with no complications, reinterventions, or reoperations, but he had never heard of a \u201cReverse Ross Procedure\u201d until he saw a patient post about it in the community. He thought it was a great topic to discuss with <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Eric-Roselli-Cleveland-Ohio.php\">Dr. Eric Roselli<\/a>, the Chief of Adult Cardiac Surgery at the Cleveland Clinic in Cleveland, Ohio. Dr. Roselli is a world-renowned heart valve expert who has performed over 3,000 heart valve operations.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/8na6CP5ji-E?si=JASDnxPDFz-RfA1U\" 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>Facts About the Reverse Ross Procedure<\/h2>\n<p>Here are the key insights shared by Dr. Roselli:<\/p>\n<ul>\n<li>Valve durability is a priority for younger patients. \u201cWhen we talk about choosing a biologic aortic valve, it\u2019s all about durability,\u201d said Dr. Roselli. He explained that the Ross Procedure can offer younger patients (typically &lt;50 years) the best chance at durability.<\/li>\n<li>Saving the patient\u2019s native valve tissue is preferable when possible. \u201cPart of the reason we reinvigorated our adult Ross program was because we were seeing patients come back with late failure of their Ross Procedure,\u201d said Dr. Roselli. \u201cWe realized we could do operations where we saved the valve. Sometimes, we turn it into a David&#8217;s Procedure if there is an aneurysm around it, and we save the valve if it\u2019s functioning well.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-5505 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/david-procedure-drawing.jpg\" alt=\"David Procedure Drawing\" width=\"650\" height=\"359\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>The Reverse Ross Procedure was pioneered by Dr. Gosta Pettersson. Dr. Roselli stated, \u201cSometimes, we do an operation pioneered by the great Dr. Gosta Pettersson called the Reverse Ross, which takes the pulmonary valve autograft from the aorta and places it back where it came from. So, you still have your living valve, and we replace the aortic valve with some other choice, either a mechanical or biologic valve.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-5506 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/heart-valve-replacement-types.jpg\" alt=\"Valve Types for Heart Valve Replacement\" width=\"650\" height=\"359\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Putting the native valve back to the pulmonary position is an excellent principle of care. \u201cI think it was around 2007 when Dr. Pettersson first started the procedure, and we\u2019ve all learned how to do it,\u201d said Dr. Roselli. \u201cIt\u2019s not for every patient, but again, we love this idea of saving the living valve. It\u2019s a great principle of care, and we\u2019ve had experience with over 50 of them. If a patient is the right fit for it, putting the valve back where it came from is a cool choice. Dr. Roselli explained that when the valve isn\u2019t functioning as well in the aortic position, which is a violent environment, but it looks like it is still functional, the autograft can replace the homograft and return to the pulmonary position.<\/li>\n<li>Pressures in the pulmonary position can be advantageous for the Reverse Ross procedure. Dr. Roselli stated, \u201cLike I always say, the pulmonary valve position is like a lazy river in a resort swimming pool, and the aortic valve is like the Pacific Ocean, a kind of Maverick\u2019s surf environment. So, you can take it and put it back, then replace the aortic valve. It\u2019s a cool way to do a late operation on a Ross, which is a nice option for a patient.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Thanks Dr. Roselli and the Cleveland Clinic!<\/h2>\n<p>On behalf of all the patients in our community, thank you, <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Eric-Roselli-Cleveland-Ohio.php\">Dr. Eric Roselli<\/a>, for everything you and your team are doing at the Cleveland Clinic!<\/p>\n<p>Related links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2024\/06\/06\/henrik-lundqvist\/\">Watch NHL superstar Henrik Lundquist interview his surgeon, Dr. Eric Roselli<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2023\/05\/12\/aortic-valve-reoperations-roselli\/\">Ask Dr. Eric Roselli: Advanced Surgical Techniques for Aortic Valve Reoperations<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/hospital\/cleveland-clinic-microsite\">Explore the Cleveland Clinic Heart Valve Microsite<\/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 patient community, we have provided a written transcript of our interview with Dr. Roselli below.<\/p>\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-5500","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\/5500","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=5500"}],"version-history":[{"count":8,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5500\/revisions"}],"predecessor-version":[{"id":5997,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5500\/revisions\/5997"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=5500"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=5500"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}