Heart - Cardiology & Cardiovascular Surgery

The Ross Procedure

The Ross procedure, also known as the pulmonary autograft procedure, is a surgical technique for replacing a diseased aortic valve. We typically use it with young, active patients without other serious chronic conditions.

During the Ross procedure, our surgeon removes your diseased aortic valve and replaces it with your own pulmonary valve, which is anatomically similar. We replace the relocated pulmonary valve with a donor heart valve. Within a few months, the pulmonary valve becomes thicker and stronger and begins to behave like an aortic valve.

The Ross procedure involves extensive reconstruction and requires us to protect your heart for a long period of time during the procedure, so we typically do it with a full sternotomy, rather than perform the procedure minimally invasively. We can shorten the skin incision on either end for cosmetic purposes.

Using your own valve means it works better than an artificial one and does not damage blood cells or cause clotting. We can perform the Ross procedure after an earlier aortic valve surgery if necessary.

The Ross procedure has several additional benefits including:

  • Decreased need for blood-thinners or anticoagulants
  • Less chance of postoperative deterioration of the valve from calcification (compared to using a valve from an animal)
  • Better size fitting as it comes from your body
  • Decreased chance of your body rejecting the valve
  • Easier blood flow regulation

What to Expect Post-Op

While the Ross procedure is less invasive than other open-heart surgeries, you will still have a hospital stay of approximately four days and restricted activity for up to eight weeks after the operation. You should wait until your cardiologist gives you the go-ahead to resume heavy lifting, vigorous manual labor, and sports, including mountain biking, sky-diving, tennis, swimming, and running.

In addition to the short-term life-style modifications, your doctor may prescribe certain medications for a few weeks after the procedure including:

  • Diuretics (water pills), so you won’t retain water
  • Pain medicine, in decreasing amounts
  • Beta blockers to help keep your blood pressure low while your pulmonary valve "learns" how to be an aortic valve
  • Angiotensin enzyme inhibitors, for additional blood pressure control or if you had severe aortic regurgitation with dilated left ventricles

We do not prescribe blood thinners after a Ross procedure because there is little chance of rejection. We may permit aspirin if you also required an aortic graft or certain other procedures.