A Technical appraisal of the Ross Procedure in AS vs AR from Dr. Stelzer

[PapaHappyStar]

I was re-reading a paper Dr. Stelzer gave me in our consult before my surgery and thought that it might be useful to put some of what I read and understood here.

In:
Paul Stelzer: "Techniques and results of the Modified Ross Procedure in Aortic Regurgitation versus Aortic Stenosis", Adv Cardiol. 2002;39:93-9

Dr. Stelzer writes:

there is really no significant difference in incidence of reoperation between AS and AR patients.

this was based on follow-up of 295 patients operated on for over ten years upto 2001. He further writes:

As for the root itself, its size and its elasticity are usually both less in patients with AS, so support is not required. The opposite is true for AR and support should almost always be used, often on both ends.

Dr. Stelzer has gained a lot of experience from operating on a multitude of adult patients with AV disease. His results are very good and he seems to be good about following up with his patients as well.

He thinks that the RP is a reasonable option to offer in selected patients upto the age of 65 ( I assume 20-25 years is his estimate of the average durability of both a tissue valve and the average life expectancy at 65 ) , but in older patients more care needs to be taken to ensure that the Ross is not complicated by major dilatation of the ascending aorta and concommitant valve issues.

 

[MichyB]

Thanks for the info!

 

[Mary]

Burair,
I'm glad you posted this information. There has been speculation that the Ross Procedure has fallen out of favor as witnessed by the smaller numbers of procedures performed. I believe one explanation is the higher selectivity of patients being judged good candidates for the procedure.

The Ross Procedure is a viable option for some, and surgeons who perform it routinely, are making their own surgical adjustments based on their learning curve.