The pulmonary autograft procedure, called the Ross procedure, is a surgical treatment for severe aortic valve disease.
With this complex surgical therapy, the faulty aortic valve is removed and replaced with the patient’s own pulmonary valve. The pulmonary valve is then replaced with a donor valve.
In the 1960s, Dr. Ronald Ross realized the aortic valve and the pulmonary valve are nearly identical. However, the pulmonary valve undergoes significantly less stress and strain than the aortic valve does. Using the patient’s own pulmonary valve to replace the diseased aortic valve, the body is more receptive to its own tissue and allows for a smoother transition and better outcomes. Surgeons also have the option of using a synthetic aortic valve, but these devices are less desirable than the patient’s own tissue and may not last as long.
The Ross procedure delivers a functioning aortic valve, reducing or eliminating symptoms and allowing the necessary blood flow to the rest of the body. Most patients experience:
The Ross procedure is a complex open-heart surgical technique that takes several hours to perform.
Patients undergo general anesthesia, so they are asleep during the surgery. Once asleep, the surgeon will use a heart-lung bypass machine that takes over the function of the heart and lungs. This machine is necessary so the heart can be stopped while the surgery is performed (the bypass machine provides heart function) and it is restarted when the procedure concludes.
The surgeon makes an incision in the chest to access the heart’s aortic and pulmonary valves. First, the diseased aortic valve is removed. Next, the pulmonary valve is moved to the location of the aortic valve so it can take over aortic-valve function. Finally, a donor pulmonary valve is implanted to replace the patient’s original pulmonary valve.
While pulmonary autograft benefits many patients with aortic valve disease, any open-heart surgical procedure involves risks. These risks include:
Patients may need a few months to fully recover from pulmonary autograft.
When surgery is complete, patients usually spend several days in the intensive care unit (ICU) to monitor heart function. When patients are discharged to go home, the recovery process may include cardiac rehabilitation to strengthen the heart and help the body adapt to the change in heart valves.
It is common to need additional surgical procedures to maintain heart health. The donor pulmonary valve usually lasts up to 20 years, and at that time an additional procedure may be necessary to repeat the process with a new donor valve.
The Valve and Structural Heart program at Memorial Hermann has a proven track record as a leader in complex surgical procedures. With a team of experienced surgeons and the latest technological advances, we are specially qualified to handle complicated cardiac conditions with the most effective therapies available.
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