Ross Procedure

Abstract

Although replacement of the aortic valve has become relatively a simple procedure it is not a procedure without complications. Some of these complications are patient-related and others are prosthesis-related. Life long risk of thromboembolism, valve thrombosis, complications of anticoagulants besides risk of endocarditis still constitute serious problems (Harada et al., 1990). Homograft valves in the aortic position provide an almost ideal alternative for aorti..: valve replacement. Degeneration and calcification have evolved as serious draw-backs documented by long term follow up of aortic homografts (Penta eta/., 1984). Pulmonary autograft replacement of'tlyaortic valve, accomplished first by Donald Ross in 1967, has the potential to be a permanent valve replacement. It is viable. can grow. can respond to iunjury by internal repair, and has hemodynamic dwracteristics identical to the normal aortic valve. it does not require anticoagulation and has essentially zero risk of thromboembolism (Elkins eta/., 1999). Because of technical problems associated with harvesting the pulmonary autograft and an early failure from improper insertion, this aortic valve replacement was met with little enthusiasm. With recognition of the problems associated with the prosthetic aortic valve replacement and the relative short term longevity of bioprosthetic and homograft valve, there has been renewed interest in the Ross operation, particularly for young patients (Joyce el al., 1995).