Ross Procedure

The Ross Procedure is a specialized aortic valve operation where the patient’s diseased aortic valve is replaced with his or her pulmonary valve, known as the pulmonary autograft. The pulmonary valve is then replaced with a human pulmonary valve (allograft or homograft). In young adults or older, particularly active patients, this procedure has several advantages over traditional aortic valve replacement with complete prostheses.

The pulmonary valve and a segment of the pulmonary artery are excised. This pulmonary segment will later be placed in the aortic position replacing the diseased aortic valve. The diseased aortic valve and tissue are removed, and the right and left coronary arteries are detached from the aorta.
The pulmonary valve and a segment of the pulmonary artery are excised. This pulmonary segment will later be placed in the aortic position replacing the diseased aortic valve. The diseased aortic valve and tissue are removed, and the right and left coronary arteries are detached from the aorta.

What happens to the missing pulmonary valve after the swap?

It is replaced with a donor valve.

Why does the Ross Procedure work?

The pulmonary valve is usually under less stress because the right pumping chamber does not need to generate as much force to push blood to the lungs. Therefore, a replacement valve can be more likely to succeed in the pulmonary position because the demand for this valve is less.

Even after the pulmonary valve is moved into the aortic valve position, it can continue to grow normally in a child who is not fully developed, and can handle the high volume of blood flow from the lower pumping chamber out to the body. There is generally not a need for long-term medication either, and so far, studies show that this procedure is useful for long-term wellness.