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Encyclopedia > Ross procedure

The Ross procedure (or pulmonary autograft) is a cardiac surgery operation where a diseased aortic valve is replaced with the person's own pulmonary valve. A pulmonary homograft (valve taken from a cadaver) is then used to replace the patient's own pulmonary valve. Pulmonary autograft replacement of the aortic valve is the operation of choice in infants and children, but its use in adults remains controversial.[1] Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... The aortic valve is one of the valves of the heart. ... The pulmonary valve (or pulmonic valve) is the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. ... A cadaver is a dead body. ...

Contents

History

The Ross procedure is named after Dr. Donald Ross - a pioneer in cardiac surgery in the UK - who proposed the procedure in 1962[2] and first performed it in 1967. Donald Ross (1872-1948) was one of the most significant golf course designers in the history of the sport. ...


Advantages / Disadvantages

Advantages

  • Freedom from thromboembolism without the need for anticoagulation.
  • The valve grows as the patient grows (i.e. children).
  • Favourable hemodynamics.
  • No foreign material present in the valve.

Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... Hemodynamics is concerned with the forces generated by the heart and the motion of blood through the cardiovascular system. ...

Disadvantages

  • Single valve disease (aortic) becomes two valve disease (aortic and pulmonary).

Pulmonary valve replacement

One of the main objections to the Ross procedure is the genesis of pulmonary valve disease in addition to aortic valve disease. Protagonists have argued that biological valves implanted in the pulmonary position would be slow to develop dysfunction, and any dysfunction would be well tolerated due to the lower pressures in the right side of the heart. Survival of homografts in the pulmonary position is good (20-year freedom from reoperation of 80%), and homograft dysfunction is infrequently implicated in the observed morbidity and mortality.[3]


Homografts (aortic or pulmonary) should be the replacement of choice; no other valve performed as well in the pulmonary position. Many homograft valves are sterilized with ethylene oxide or irradiation; methods recognized to have deleterious effects on valve performance. The results of the pulmonary autograft procedure are likely to be superior with the use of fresh homograft valves.[3] The chemical compound ethylene oxide is an important industrial chemical used as an intermediate in the production of ethylene glycol and other chemicals, and as a sterilant for foodstuffs and medical supplies. ... Irradiation is the process by which an item is exposed to radiation. ...


See also

A Bentall procedure is a cardiac surgery operation involving composite graft replacement of the ascending aorta and aortic valve, with anastomosis of the coronary arteries into the graft. ... Wikipedia does not yet have an article with this exact name. ...

References

  1. ^ Yacoub M, Klieverik L, Melina G, Edwards S, Sarathchandra P, Bogers A, Squarcia U, Sani G, van Herwerden L, Takkenberg J (2006). "An evaluation of the Ross operation in adults". J Heart Valve Dis 15 (4): 531-9. PMID 16901050. 
  2. ^ Ross D (1962). "Homograft replacement of the aortic valve". Lancet 2: 487. PMID 14494158. 
  3. ^ a b Chambers J, Somerville J, Stone S, Ross D (1997). "Pulmonary autograft procedure for aortic valve disease: long-term results of the pioneer series". Circulation 96 (7): 2206-14. PMID 9337191. 

External links

  • Cardiac Surgery in the Adult - Pulmonary autograft
v • d • e
Health Science – Medicine - Surgery - Cardiac surgery

Surgeries/Surgical diseases of the aorta
Aortic aneurysm, Aortic dissection, Bentall procedure, David procedure, Marfan syndrome Health sciences are the group of disciplines of applied science dealing with human and animal health. ... medicines, see medication and pharmacology. ... A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... Cardiac surgery is surgery on the heart, typically to treat complications of ischemic heart disease (e. ... The aorta (generally pronounced or ay-orta) is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation. ... An aortic aneurysm is a general term for any swelling (dilatation or aneurysm) of the aorta, usually representing an underlying weakness in the wall of the aorta at that location. ... Aortic dissection is a tear in the wall of the aorta (the largest artery of the body). ... A Bentall procedure is a cardiac surgery operation involving composite graft replacement of the ascending aorta and aortic valve, with anastomosis of the coronary arteries into the graft. ... Valve-sparing aortic root replacement (also known as the David procedure) is a cardiac surgery procedure involving replacement of the ascending aorta without replacement of the aortic valve. ... This does not cite its references or sources. ...


Valvular Heart Disease
Aortic valve repair, Aortic valve replacement, Ross procedure, Mitral valve repair, Mitral valve replacement, Tricuspid valve repair, Tricuspid valve replacement Wikipedia does not yet have an article with this exact name. ... Aortic valve repair is a surgical procedure used to correct some aortic valve disorders. ... The aortic valve is one of the valves of the heart. ... Mitral valve repair involves the replacement of stenified vitrious fibres that have frayed off of the wall of the duct. ... Mitral valve replacement is a cardiac surgery procedure in which a patients mitral valve is replaced by a different valve. ...


Surgeries/Surgical diseases of the myocardium
Coronary artery bypass surgery, Ischemic VSD, Maze procedure, Septal myectomy, Ventricular reduction Myocardium is the muscular tissue of the heart. ... Early in a coronary artery bypass surgery during vein harvesting from the legs (left of image) and the establishment of bypass (placement of the aortic cannula) (bottom of image). ... A ventricular septal defect (or VSD) is a defect in the ventricular septum (the wall dividing the left and right ventricles of the heart). ... The maze procedure is a collection of cardiac surgery procedures intended to cure atrial fibrillation (AF), a common disturbance of heart rhythm. ...


Heart transplantation
Ischemic cardiomyopathy, Hypertrophic cardiomyopathy, Ventricular assist device Opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium. ... Hypertrophic cardiomyopathy, or HCM, is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause. ... A Ventricular assist device, or VAD, is mechanical device that is used to partially or completely replace the function of a failing heart. ...


Congenital heart disease
Atrial septal defect, Ebstein's anomaly, Pulmonary stenosis, Tetralogy of Fallot, Transposition of the great arteries, Ventricular septal defect Cross-section of a healthy heart. ... Atrial septal defects (ASD) are a group of congenital heart diseases that enables communication between atria of the heart and may involve the interatrial septum. ... Ebsteins anomaly is a congenital heart defect in which the opening of the tricuspid valve is displaced towards the apex of the right ventricle of the heart. ... Pulmonary stenosis is a congenital medical condition in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. ... The tetralogy of Fallot is a congenital heart defect which classically has four anatomical components. ... Transposition of the Great Arteries (TGA), also referred to as Transposition of the Great Vessels (TGV), is a cyanotic congenital heart defect (CHD), in which the primary arteries of the heart (the aorta and the pulmonary artery) are transposed. ... A ventricular septal defect (or VSD) is a defect in the ventricular septum (the wall dividing the left and right ventricles of the heart). ...



 

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