Ross Procedure (Pulmonary Autograft Procedure)

What Is the Aortic Valve?

The Ross procedure, also called the pulmonary autograft procedure, is a type of heart surgery that treats aortic valve problems (the main valve that sends blood from your heart to your body) in active patients ages 60 and younger.

You will receive general anesthesia to remain asleep throughout the operation. During the Ross procedure, your aortic disease surgeon will:

make one long incision (cut) down the center of your chest (sternotomy incision) to access your heart.
remove the aortic root, including your aortic valve and the blood vessels around it.
remove your pulmonary root (valve that allows blood to flow from your heart to your lungs) and the main pulmonary artery and a small amount of muscle from your heart’s right ventricle.
move and stitch the pulmonary valve into the aortic position.
attach the coronary blood vessels to the pulmonary valve in its new position.
replace your pulmonary valve with a donor valve.

How Long Does the Ross Procedure Last?

The entire procedure takes six to eight hours.

Candidate Criteria for Ross Procedure

You may be a candidate for the Ross procedure if you are 60 or younger, active, have no major comorbidities, and have:

You must also have a well-functioning pulmonary valve to qualify for the Ross procedure. Our surgeons use diagnostic tests to evaluate your heart valves before surgery, including:

chest X-rays,
CT scans,
echocardiograms, or
electrocardiograms.

For patients who are candidates for the Ross procedure, this technique has better outcomes than other types of artificial aortic valve replacement. Your aortic valve carries a high volume of blood. When you replace that valve with your own living valve, it works better than an artificial one and does not damage blood cells or cause clotting.

Find an Aortic Disease Surgeon

Ross Procedure Pros & Cons

One of the most significant advantages of the Ross procedure is its excellent long-term survival rates and lower chance of postoperative deterioration. Additional benefits include:

decreased need for blood thinners or anticoagulants,
low reoperation rates,
low risk of infection, and
no exercise intolerance or limitations.

In fact, the Ross procedure is the only procedure for aortic valve replacement that brings your survival rate to a typical rate compared to an age-matched control population.

Due to the complexity of the procedure, Ross surgery is not a good treatment option for patients who have:

a damaged pulmonary valve or
multiple comorbidities.

How to Prepare for Surgery

Your surgeon will give you instructions to prepare for Ross surgery. You may need to stop taking certain medicines, such as blood thinners, for a brief period before the operation. You’ll need to avoid eating or drinking after midnight the night before surgery.

Ross Procedure Recovery Time

You’ll stay in the hospital for up to one week after a Ross procedure. Immediately after the operation, you will stay in the intensive care unit (ICU) for one to two days. Then you will move to a recovery room for another three to four days.

It takes up to three to four weeks to recover from a Ross procedure. You’ll avoid heavy lifting during this period. You’ll be able to walk when you leave the hospital and should gradually increase your activity levels after returning home.

Ross Procedure Complications

The immediate risk of complications from a Ross procedure is less than 2 percent. Possible complications include:

bleeding,
heart attack, or
stroke.

Ross Procedure Survival Rate

The Ross procedure has up to a 93 percent survival rate at 15 years after surgery. Ross procedure survival is better than the survival rates associated with using a tissue or mechanical valve to replace the aortic valve.

Life after a Ross Procedure

You’ll need to monitor your blood pressure strictly after a Ross procedure. Your cardiologist will give you instructions to take your blood pressure at home every day.

You’ll need to keep your systolic pressure (the top number of your blood pressure measurement) under 110 for at least one year after the operation. You’ll see your cardiologist every few months in the first year after surgery. After that, you’ll see your cardiologist at least once a year for the rest of your life to ensure your heart valves are still working properly.

Why Choose University of Utah �ǿմ�ý?

Our aortic disease surgeons are among the most experienced, best surgeons in the Ross procedure in the Mountain West region. We have special training and expertise in performing this surgery in both children and adults. We are among the highest-volume centers in our region for aortic disease surgery.

It’s important to know what your options are for aortic disease treatment. Our specialists offer a full range of treatment options and help you find the best solution for you.

Schedule a Consultation

Need to see an aortic specialist? First thing to do is get a referral from your primary care doctor. Once you have referral and have made an appointment, you can prepare for your appointment by:

Letting your insurance know you have an appointment and reviewing your insurance coverage.
Having a copy of your medical history ready.

Call 801-585-6740 to schedule an appointment.

Participate in Clinical Trials for Aortic Disease

TREO Post Approval Study

Contact the Destination Care Program

The Destination Care Program is an initiative by U of U �ǿմ�ý focusing on care for our out-of-state patients. We are here to help you find the services and information you need. Feel free to contact us:

Email: DestinationCare@hsc.utah.edu
Phone: 801-587-6365