Ross Procedure

Firstly, I'm not a doctor. And even if someone in here is an MD, take it with a grain of salt. Has the surgery gotten better since 1998? Almost certainly in the high-volume centres. Does that mean it's right for you? Not necessarily.

I watched four extremely experienced academic cardiac surgeons at a conference discuss the treatment of aortic valve issues in young patients, and there were fair arguments for the Ross, mech AVR and tissue AVR (often or young women who want to have children as a bridge to a mech AVR in 10-15 years). A surgeon I work closely with has described the Ross as a niche procedure - he would recommend it for highly-active young people who are otherwise very healthy, but he certainly doesn't think it's for everyone. Mech valves have gotten a lot better since 1998 as well. Most of the papers I've read show comparable survival between mech AVR and Ross.

As you're almost certainly aware, this surgery is a big deal, and assuming your last surgery was open-heart, you're a re-do and considered higher risk. You're also comparatively young, which means a third and possibly fourth surgery aren't outside the realm of possibility. Try to get a referral to an experienced cardiac surgeon at a high-volume centre who does a lot of AVRs and Ross procedures. Think about questions like these:

  • How strongly do you feel about anti coagulation?
  • If you're a woman, do you want to have your own children? That's often incompatible with mech valves and Coumadin
  • What's your activity level day-to-day? What's important to you? Are you a world-travelling rock-climber or surfer, or are you a fairly sedentary person?
  • Is a minimally-invasive AVR an option? Would it be worth it for the reduced recovery time?

If you do decide on a Ross, find a surgeon who specializes in the procedure if you possibly can. Best of luck with it.

/r/medical Thread