Why is the Ross Procedure better than other aortic valve replacement procedures?
There are numerous reasons why the Ross Procedure is better than the alternatives:
- No blood-thinners (anticoagulants) are required. If the aortic valve is replaced with a mechanical valve, the patient must take anticoagulants for the rest of his or her life. These medications have a small but cumulative risk of excess bleeding or hemorrhage and the effects of the anticoagulants must be monitored with a blood test every 3 or 4 weeks and the dosage adjusted accordingly. Underdosing may lead to embolic events such as stroke or acute thrombosis (sudden valve failure due to clotting).
- No postoperative deterioration of the valve from calcification. This can be a problem for patients who have their valve replaced with one from an animal (pig or cow or horse). The younger the patient, the less durable the animal valve.
- The patient's pulmonary valve is the right size to replace the aortic valve.
- No artificial material is used for the new aortic valve. This avoids many problems including rejection. Since the new aortic valve is created from the patient's own tissue, the tissue is alive and healthy, instead of being frozen or chemically treated.
What is the success rate of the operation?
The success rate is over 97%. Long-term results have been excellent. More than 80% of the patients who have undergone this surgery are still alive after 20 years and less than 15% of patients need additional valve procedures. Seventy-five percent were free from any other event including endocarditis, degeneration of the pulmonary autograft, reoperation and death.
Once an aortic valve problem is detected, does the procedure have to be done immediately?
This depends on the patient's condition. For example, if a patient has syncope (fainting spells), immediate surgery may be required. In other cases the patient's condition can be monitored before determining that surgery is necessary.
Can the Ross Procedure be done as a secondary operation after previous aortic valve surgery?
In most cases, the answer is yes. It may be somewhat more difficult, however, due to scar tissue around the heart.
Will I need a blood transfusion?
This depends on the patient, but the answer is probably no. To date, about 1/4 of patients receiving the Ross Procedure have required a blood transfusion
What is the recuperation time?
Usually, a patient is able to go home about 4 days after surgery. After 4 to 6 weeks many patients are able to return to work and resume normal activity, including extensive walking and even jogging. Heavy lifting should be delayed for about 8 weeks. Patients may then return to a full level of activity including vigorous manual labor or sports.
What later follow-up is needed?
Before being discharged from the hospital, an echocardiogram is done of the patient's heart. An echocardiogram should be performed a year after surgery, and is recommended biannually thereafter
What about antibiotics for future dental procedures?
To avoid endocarditis (heart infection) standard guidelines for antibiotics from the American Heart Association should be followed for "deep" dental work, like extractions, root canal, or deep periodontal work like scaling.