{"id":5934,"date":"2025-07-17T16:57:53","date_gmt":"2025-07-17T16:57:53","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=5934"},"modified":"2025-08-15T03:11:56","modified_gmt":"2025-08-15T03:11:56","slug":"ross-procedure-surgeon-selection","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/ross-procedure-surgeon-selection\/","title":{"rendered":"Surgeon Q&#038;A: How To Select A Ross Procedure Surgeon"},"content":{"rendered":"<p>Young and middle-aged patients weighing their options for an aortic valve replacement are often drawn to the <a href=\"https:\/\/www.heart-valve-surgery.com\/ross-procedure-aortic-disease\">Ross Procedure<\/a>. Although it is a technically complex operation requiring an expert surgeon practicing in a high-volume center, it has the potential for long-term, viable aortic valve replacement without the need for lifelong anticoagulation. In fact, <a href=\"https:\/\/jamanetwork.com\/journals\/jamacardiology\/fullarticle\/2811496\">new research<\/a> published in the Journal of the American Medicine Association shows that the survival of Ross Procedure patients mirrors the general population. This means that Ross Procedure patients had the same life expectancy as people who did not have aortic valve disease.<\/p>\n<p>So you know, I had a Ross Procedure nearly 20 years ago with great success. I\u2019ve had no reoperation and no further intervention. \u00a0My heart is doing great. However, many patients just receiving the news that they need an aortic valve replacement may not have heard of the Ross Procedure (or know very little about it).<\/p>\n<p>I recently met with <a href=\"https:\/\/www.cedars-sinai.org\/provider\/richard-kim-3180245.html?_ga=2.49365923.446357360.1634831646-1907320216.1634688247&amp;_gac=1.61941342.1634688251.CjwKCAjw2bmLBhBREiwAZ6ugo7GB27SMhvsKaJGPKzeS61cBD1l7G3pCQr3JNu_BMojtIJAhlUE2GRoCN9YQAvD_BwE\">Dr. Richard Kim<\/a>, the Director of Pediatric and Congenital Cardiac Surgery at Cedars-Sinai in Los Angeles, California, to learn more about the Ross Procedure and the importance of finding a surgeon with the proper expertise to operate.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/Q5Fb-wj0lQ8?rel=0?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><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>Key Learnings About Ross Procedure Surgeon Selection<\/h2>\n<p>Here are important insights shared by Dr. Kim:<\/p>\n<ul>\n<li>Can you explain the Ross Procedure for patients who are not familiar with it? \u201cThe Ross Procedure is for patients who have severe aortic valve disease and need to have their aortic valve replaced,\u201d Dr. Kim said. \u201cGenerally speaking, it\u2019s for younger patients who are 50 or younger or want to maintain an active lifestyle.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>The Ross Procedure is a very complex operation. Dr. Kim explained that the Ross Procedure is significantly more challenging and takes longer to perform. He said that the surgeon removes the patient\u2019s pulmonary valve from another part of the heart and moves it to the aortic position. The surgeon then replaces the patient\u2019s pulmonary valve with an off-the-shelf replacement.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Pressures within the heart impact valve function and durability. \u201cBecause of the differences in the pressures in the heart, this combination of replacements has the potential to last significantly longer than your standard aortic valve replacement,\u201d said Dr. Kim. Dr. Kim explained that the aortic valve is under tremendous stress, particularly for younger patients. \u201cThe bioprosthetic valve commonly used generally only lasts ten years or less,\u201d he said. \u201cMechanical valves require blood thinners, and it\u2019s something that most people find difficult to manage. It\u2019s also important that we use the native pulmonary valve in a high-stress position. Your own native tissue can adapt over time, so it\u2019s not unusual for this valve to last 20 years or more. Most importantly, patients who undergo a successful Ross Procedure have the potential for the longest life expectancy of any patient undergoing any aortic valve replacement.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-5939 size-full\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/ross-procedure-considerations.jpg\" alt=\"Ross Procedure Considerations\" width=\"650\" height=\"360\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>How do patients know if the surgeon they\u2019re talking to is an experienced Ross Procedure surgeon? \u201cLike all things, experience matters,\u201d said Dr. Kim. \u201cParticularly for the Ross Procedure, which is quite a complicated operation. The Ross has several nuances and potential pitfalls, and you have to do enough to understand how to manage each problem. For instance, if the valve is small, do you have to increase the size of the valve? How do you know if the valve is going to work? Is the valve particularly problematic? Is there a way to change your technique to save a valve that is not quite as good as you would like?\u201d Dr. Kim noted that he and several of his colleagues recently published a <a href=\"https:\/\/www.annalsthoracicsurgery.org\/article\/S0003-4975(22)00973-0\/pdf\">paper<\/a> looking at all the Ross Procedures done in children under 18 across the United States for over 20 years. More than half of the procedures were done on kids of adult size.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-5938 size-full\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/ross-procedure-children-paper.jpg\" alt=\"Ross Procedure Children\" width=\"650\" height=\"361\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Kim made some conclusions about how the children\u2019s study may compare to adults having a Ross Procedure. \u201cAlthough a direct comparison to adults can\u2019t really be made, I think some of the conclusions hold true,\u201d he said. \u201cThe first conclusion is that across 120 different sites, the overall mortality in adult-age Ross patients was less than one percent. So you can have excellent outcomes across the United States at many different centers. The second conclusion is that Ross Centers and these studies averaged approximately six Ross Procedures per year at the highest volume. So, very few centers are doing more than that every year, and I think that holds for adults, also. Myself, I do about 10 to 15 Ross Procedures per year. So, who&#8217;s to say if you wanted to know what the absolute number is? Is it 5, 10, 25, 100?\u201d Dr. Kim explained that asking how many Ross Procedures a surgeon or center performs may not be the right question. \u201cI think you need to discuss with your surgeon and ask whether or not they\u2019re truly comfortable with the procedure.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>What is the youngest patient that Dr. Kim operated on with the Ross Procedure? \u201cThe very youngest patients of the Ross Procedure are usually patients we are trying to salvage a valve. For instance, if a child is born with a congenital problem with a valve, their first procedure is usually a balloon valvotomy, which doesn\u2019t work so well, and we end up having to do the Ross Procedure. So, the youngest patient I\u2019ve done a Ross Procedure on is just a few days old.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Given all you know, what is your advice for a patient or parent who thinks the Ross Procedure could be the right therapy for them? \u201cI think the most important thing is for parents or patients to have an open, frank conversation with their surgeon,\u201d said Dr. Kim. \u201cAsk the surgeon the questions that matter to you the most. Ask yourself whether or not you believe your surgeon can do the procedures you want them to do or that they are proposing to do. And finally, take a real good measure of whether or not your surgeon is taking the time to address your concerns and questions.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h1>Thanks Dr. Kim and Cedars-Sinai!<\/h1>\n<p>From everyone in the HeartValveSurgery.com community, many thanks to <a href=\"https:\/\/www.cedars-sinai.org\/provider\/richard-kim-3180245.html?_ga=2.49365923.446357360.1634831646-1907320216.1634688247&amp;_gac=1.61941342.1634688251.CjwKCAjw2bmLBhBREiwAZ6ugo7GB27SMhvsKaJGPKzeS61cBD1l7G3pCQr3JNu_BMojtIJAhlUE2GRoCN9YQAvD_BwE\">Dr. Richard Kim<\/a>, for sharing your knowledge and insight into the Ross Procedure and how to select the right surgeon. We also want to thank Cedars-Sinai Medical Center for continuing to care for our heart valve patients!<\/p>\n<p>Related Links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/videos\/pediatric-richard-kim-md\">Pediatric Heart Valve Surgery: Surgeon Insights with Dr. Richard Kim<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/weight-gain-after-surgery\/\">Weight Gain After Heart Surgery: What Should Patients Know?<\/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. Kim 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-5934","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\/5934","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=5934"}],"version-history":[{"count":11,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5934\/revisions"}],"predecessor-version":[{"id":6153,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5934\/revisions\/6153"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=5934"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=5934"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}