Ross procedure

Ross procedure involves the use of a pulmonary homograft for surgical aortic valve replacement.

It can be used to treat a broad array of aortic valve pathologies, often aortic stenosis.

  • multivessel coronary artery disease
  • multiple valvular pathologies in which a second valve replacement device is required
  • extremes of age
  • severely depressed left ventricular function

This involves the surgical replacement of the aortic valve and root with the patient’s native pulmonary valve and proximal pulmonary artery (homograft). Then the pulmonary valve and right ventricular outflow tract (RVOT) is replaced by a cadaveric pulmonary valve (allograft).

Advantages 
  • no need for anticoagulation
  • the valve grows as the patient grows in children
  • favourable haemodynamics
  • no prosthetic material present in the valve
Disadvantages​
  • potentially converting a single valve problem into a two valve problem

Reported complications include:

  • aortic insufficiency
  • right ventricular outlet obstruction and insufficiency
  • aortic autograft dilatation
  • pulmonary allograft stenosis
  • aneurysms

Cardiac MRI is useful for evaluating post-Ross procedure patients. The main limitation of the procedure is the need for reoperation in some patients.

This procedure was developed in 1967 by a British surgeon, Dr Donald Ross, and has undergone several refinements since.

Share article

Article information

rID: 41164
System: Cardiac
Section: Pathology
Synonyms or Alternate Spellings:

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1: post Ross procedure
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.