The Ross Procedure

Abstract

The Ross procedure provides a unique opportunity for non-elderly adult patients whose preferences do not align with the outcome provided by mechanical valve replacement. The acceptance of this procedure has been slow because of the technical demands of the operation and the inherent need for reconstruction of the right ventricular outflow tract, thereby placing two valves at risk. The advantages of the autograft valve include growth potential, optimal hemodynamic performance, and freedom from anticoagulation and hemolysis. However, concerns regarding potential dilatation of the autograft, reoperation for autograft dysfunction, and replacement of right ventricular outflow tract conduits persist. Further, doubts have been expressed by others regarding the indications for the Ross operation in patients with a bicuspid aortic valve and with aortic valve insufficiency. This chapter evaluates existing evidence on the safety and efficacy of Ross procedure for adult patients and focuses on technical aspects of the procedure.