Considering the Ross procedure

[daVinci]

So the time has come for surgery and I'm thinking about options and doing all the research I can to make the most informed and best suited decision for myself and my future.

I've searched literature and previous posts to try and understand more about the Ross procedure and the experiences of those that have undergone it.

Ideally, I'd like another 20 years without needing anticoagulation (in my early 30s now), but like to think I'd be accepting of and manage warfarin well in the longer term. Opening up problems with a second valve is the big worry for me, that and lack of data beyond 20 or so years post Ross.

Anyone here had the Ross and care to share their experience?

 

[pellicle]

Hi

Ideally, I'd like another 20 years without needing anticoagulation (in my early 30s now),

makes good logical sense ... knowing me (and knowing some others) I can say its not always a good time in life to be adding one more thing ... even if it is reasonably simple. I'm glad that your thinking ahead into life after (and not just about "the surgery).

but like to think I'd be accepting of and manage warfarin well in the longer term.

that's good!

Opening up problems with a second valve is the big worry for me, that and lack of data beyond 20 or so years post Ross.

correct ... its a craps shoot ... to me the cost benefit doesn't stack up, but then I got 10 years out of my homograft (at age 28) and so when it was redo time I only needed the Aortic valve (and an aneurysm fixing up).

Anyone here had the Ross and care to share their experience?

While you are waiting for others to reply here's a quick search I did of prior posts

https://www.valvereplacement.org/threads/endocarditis-leading-to-avr-my-story.889366/post-929467

This person wanted it
https://www.valvereplacement.org/th...e-who-had-a-ross-procedure.888820/post-920892

but sadly got Endo and ...
https://www.valvereplacement.org/threads/endocarditis-leading-to-avr-my-story.889366/post-929467


lastly my own view

https://www.valvereplacement.org/threads/ross-vs-mechanical.889507/#post-931593

also the Ross increases time on the cross clamp both on the initial surgery and on subsequent redo's. This is why you'd want to avoid that

https://www.sciencedirect.com/science/article/pii/S1743919110004619


Lastly its all very personal but as a patient you need to make informed choices so that you can balance the life risk:reward ratio.

Best Wishes

 

[pellicle]

oh

https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.118.004748

HTH

 

[daVinci]

oh

https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.118.004748

HTH

Thanks for sending all these through. I'd come across most already fortunately.

A decade or two without anticoagulation is more important to me as a woman than it would be to most patients my age. I feel I would be accepting of switching to mechanical valves down the line were I to have issues with the Ross. It's just not wanting to be in that cohort with early failure I suppose and get the benefit and freedom of life without anticoagulation whilst I'm younger. Nothing in life is certain, but strongly inclined to go with the Ross at present.

 

[pellicle]

I'd come across most already

that's good, and shows you've been reading widely.

Nothing in life is certain,

agreed ... nothing is certain, only statistical. Trust me I know all to well.

any reason why you aren't looking at cryopreserved homograft?

https://pubmed.ncbi.nlm.nih.gov/11380096/

Methods: Between December 1969 and December 1998, 1,022 patients (males 65%; median age 49 years; range: 1-80 years) received either a subcoronary (n = 635), an intraluminal cylinder (n = 35), or a full root replacement (n = 352). There was a unique result of a 99.3% complete follow up at the end of this 29-year experience.
... for all cryopreserved valves, at 15 years, the freedom was ... 85% (21-40 years), 81% (41-60 years) and 94% (>60 years)...

I was operated on at 28 and had no need of ACT in the twenty years I got from my valve.

Best Wishes