The Data Behind the Ross Procedure
The Ross Procedure is the only option for aortic valve replacement that has resulted in survival, or life expectancy, similar to that of matched general population and those who have not undergone aortic valve replacement.1
- Numerous studies across various countries, totaling over 3,500 patients (at a mean age of 38 years at the time of surgery) have shown a survival rate of over 90% at 15 years after surgery. This means that 15 years after undergoing the Ross Procedure, 90% of these patients are still alive.2-9
- In a group of 1,501 young patients who underwent a Ross Procedure or prosthetic (mechanical or tissue) aortic valve replacement between 2000 and 2012 in the UK, it was found that the Ross Procedure was superior to mechanical valves and tissue valves in clinical outcomes.10
The Reality of Reoperation
A common misconception is that the Ross Procedure takes a one-valve disease and turns it into a two-valve disease and can result in early reoperation of the autograft (the new aortic valve) or the homograft (the human donor valve in the pulmonary position). However, the data paints a different picture.
Fifteen (15) years after surgery, almost 9 out of 10 patients continue to live without requiring a second intervention of either the pulmonary autograft or the homograft.2-9 In addition, with today’s technology, most re-interventions on the homograft in the pulmonary position can be done using catheter-based approaches.11,12 An important point to remember is that long-term durability of the Ross Procedure is largely dependent on the expertise of the surgeon. It is therefore important to seek high-volume centers of expertise with aortic surgery, and specifically with the Ross Procedure.13
Which Line Do You Want To Be on When It Comes To the Reality of Reoperation?
Figure C – Comparison of Long-Term Outcomes among the Ross Procedure, Mechanical Aortic Valve Replacement,
and Bioprosthesis for Young Adults 10
- Ouzounian M et al., J Thorac Cardiovasc Surg 2017;154:778-82.
- El Hamamsy I et al., The Lancet 2010;376(9740):524-31.
- Sievers H et al., Euro J Cardio-Thorac Surg 2016;49:212-18.
- David T et al., J Thorac Cardiovasc Surg 2014;147(1):85-94.
- Skillington P et al., Ann Thorac Surg 2013;96:823–9.
- Kalfa D et al., Euro J Cardio-Thorac Surg 2015;47:159-67.
- Andreas M et al., Ann Thorac Surg 2014;97:182–8.
- Mazine A et al., Circulation 2016;134(8):576-85.
- Martin E et al., JACC 2017;70(15):1890-99.
- Sharabiani M et al., JACC 2016;67(24):2858-70.
- Ghobrial J et al. Curr Cariol Rep 2016;18(4):33.
- Cheatham J et al. Circulation 2015;131:1960-70.
- Bouhout I et al., Interact CardioVasc Thorac Surg 2017;24:41-7.