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What is the proper place of the ross procedure in our modern armamentarium?

  • Valvular Heart Disease
  • Published:
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“As I see it, you’re still short one valve.” Norman Shumway

Abstract

Despite nearly four decades of experience, the role of pulmonary valve autotransplantation (Ross procedure) in the treatment of aortic valve disease in adults and children continues to evolve and remains controversial. As the picture of late results has unfolded, alternating waves of enthusiasm and caution have characterized its use and have led to ongoing refinements in indications and operative technique. At present, it is seen as indispensable in the treatment of aortic valve disease in infants and small children (for whom no satisfactory replacement alternative exixts and for whom growth is essential), attractive for adolescents and young adults who wish to avoid anticoagulants because of childbirth and lifestyle considerations, a reasonable option for selected adults who desire biologic solutions with potentially better durability than conventional bioprostheses, and contraindicated for the elderly and those with connective tissue disorders. Young patients with bicuspid aortic valve are the most common potential recipients, but also the most controversial, because of the risk of autograft dilatation. Optimal matching of prosthesis to patient is a clinical challenge for all caretakers involved in the treatment of valvular heart disease; this review provides guidelines to identify those patients who will benefit most from the Ross procedure, and those for whom it is inadvisable.

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Authors and Affiliations

  1. Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, 600 N. Wolfe Street, Blalock 618, 21287, Baltimore, MD, USA

    Duke E. Cameron MD

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  1. Duke E. Cameron MD
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  2. Luca A. Vricella MD
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Correspondence to Duke E. Cameron MD.

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Cameron, D.E., Vricella, L.A. What is the proper place of the ross procedure in our modern armamentarium?. Curr Cardiol Rep 9, 93–98 (2007). https://doi.org/10.1007/BF02938334

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