Cor Vasa 2017, 59(1):e71-e76 | DOI: 10.1016/j.crvasa.2017.01.018

Current status of the Ross procedure in aortic valve surgery

Jan Vojáček^a,*, Ismail El-Hamamsy^b, Jiří Ondrášek^c, Pavel Žáček^a, Petr Fila^c, Martin Voborník^a, Jaroslav Špatenka^d

^a Kardiochirurgická klinika, Lékařská fakulta Univerzity Karlovy v Hradci Králové a Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

^b Division of Cardiac Surgery, Aortic and Connective Tissue Clinic, Montreal Heart Institute, Université de Montréal, Kanada

^c Centrum kardiovaskulární a transplantační chirurgie, Brno, Česká republika

^d Oddělení transplantací a tkáňové banky, Fakultní nemocnice v Motole, Praha, Česká republika

The Ross procedure represents a unique surgical concept of unrepairable diseased aortic valve replacement by patient's own pulmonary valve (pulmonary autograft). After pulmonary valve removal, the right ventricle outflow tract is reconstructed by pulmonary allograft transplantation. Pulmonary valve in aortic position (pulmonary autograft) displays excellent hemodynamic features, viability with a growth-potential (in children) and a low risk of thromboembolism and infective endocarditis unparalleled to other heart valve substitutes. Despite the advantages of a pulmonary autograft the Ross procedures arouse controversies and surgical respect due to its technical complexity and involvement of another valve into a risk of complications and potential reoperation. Renaissance of interest in Ross procedure has been caused by recent operation standardization, knowledge of critical procedural steps and confirmation of excellent long-term results. Ross procedure performed in dedicated centers with utmost attention to technical details securing long-term durability of both the autograft and allograft is an attractive option namely for young patients with aortic valve disease.

Keywords: Anticoagulation; Aortic stenosis; Pulmonary allograft; Pulmonary autograft; Quality of life; Ross procedure

Received: November 22, 2016; Accepted: January 12, 2017; Published: February 1, 2017  Show citation