Maryland Heart Center

Surgical Treatments

The Ross Procedure

Named in honor of its creator, English surgeon Dr. Donald Ross, in the late 1960s, the Ross Procedure is a innovative means of valvular replacement for the aortic valve, particularly in children. Although cardiac surgeons in this country began using the procedure in the 1980s, it is still performed only at a very selected group of centers.

Advantages:

Although the surgical procedure itself is technically more demanding, it has some advantages over traditional procedures. For example, when the aortic valve is replaced with a mechanical device, there is a need for anticoagulation therapy (blood thinners) for life. Also, there is the risk of infection of the mechanical valve. Also, when a mechanical valve is used in a young child, the valve will not grow as the child grows. Biological valves, on the other hand (porcine valves), do not require blood thinners, but in young patients, most have to be replaced in 7-10 years.

When the Ross procedure is used, the patient's own pulmonary valve becomes the prosthesis for the aortic replacement. The pulmonary valve and aortic valve are both very similar in function and shape. Following the Ross procedure, there is no need for blood thinners, the patient has a higher resistance to infection (the tissue is alive), and the new valve can potentially grow as the child grows.

The mortality for this surgery is as low as other similar surgical procedures. The empty place left by the pulmonary valve is replaced, in most cases, with a homograft (frozen human tissue) that accomplishes the same function. Eventually, the homograft may require replacement, but this is a much simpler surgery than an aortic valve reoperation.

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