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Current status of the Ross procedure in aortic valve surgery

Publication at Second Faculty of Medicine, Faculty of Medicine in Hradec Králové |
2017

Abstract

The Ross procedure represents a unique surgical concept of unrepairable diseased aortic valve replacement by patient's own pulmonary valve (pulmonary autograft). After pulmonary valve removal, the right ventricle outflow tract is reconstructed by pulmonary allograft transplantation.

Pulmonary valve in aortic position (pulmonary autograft) displays excellent hemodynamic features, viability with a growth-potential (in children) and low risk of thromboembolism and infective endocarditis unparalleled to other heart valve substitutes. Despite the advantages of pulmonary autograft the Ross procedures arouse controversies and surgical respect due to its technical complexity and involvement of another valve into a risk of complications and potential reoperation.

Renaissance of interest in Ross procedure has been caused by recent operation standardization, knowledge of critical procedural steps and confirmation of excelent long-term results. Ross procedure performed in dedicated centers with utmost attention to technical details securing long-term durability of both the autograft and allograft is an attractive option namely for young patients with aortic valve disease.