When I had my Ross Procedure done I chose it for two reasons at the time.
The reoperation rate (at that time) was 15% at 20 years. I think it has risen considerably which is why it has fallen out of favor. They have made improvements to the procedure but I don't know what the current reoperation rates are now.
http://www.hsforum.com/stories/storyReader$1472
I had endocarditis before my surgery and the Ross Procedure is more resistant to endocarditis than either tissue or mechanical valves.
As far as the durability of the CE Perimount bovine pericardial tissue valve, patients in the 60-70 age group had a 92% freedom from explant for structural valve deterioration at 20 years.
http://ht.edwards.com/resourcegallery/products/heartvalves/pdfs/durability_ar00785.pdf
I am a firm believer that transcatheter valve replacement will be routine, especially for the elderly, within the next 10 years. My surgeon is leading the clinical trials at Duke using the CoreValve. He recommended the CE Perimount bovine pericardial valve for me because he is positive (from running the trial) that this type of valve replacement will be the standard for older patients and patients that have already had multiple surgeries. If I get the "average life expectancy" out of my valve I will be in my mid 60's and I have already had 2 surgeries to date. When that day comes when it is time to replace it I will weigh my options and choose the best option that will last the rest of my life regardless of the type of valve that is, but I am hoping it will be the transcatheter method.
Of course there is the choice of using a mechanical valve. Barring complications this will last you the rest of your life. ACT comes along with it but there is no guarantee you won't need to take it for other reasons if you have a tissue valve (like a-fib).
Really I would get an opinion from your surgeon on using the Ross Procedure and possibly a 2nd opinion. IMO (and I am not a medical professional) with the durability of tissue valves today, the promising results of transcatheter valve clinical trials and the advancement in mechanical valves these would be my choices. And I don't say this because my Ross Procedure didn't work out. I felt I went with the best option with the information I had at the time and it just didn't work out for me. There are many others out there that have had the RP and are doing great after many years.
The reoperation rate (at that time) was 15% at 20 years. I think it has risen considerably which is why it has fallen out of favor. They have made improvements to the procedure but I don't know what the current reoperation rates are now.
http://www.hsforum.com/stories/storyReader$1472
I had endocarditis before my surgery and the Ross Procedure is more resistant to endocarditis than either tissue or mechanical valves.
As far as the durability of the CE Perimount bovine pericardial tissue valve, patients in the 60-70 age group had a 92% freedom from explant for structural valve deterioration at 20 years.
http://ht.edwards.com/resourcegallery/products/heartvalves/pdfs/durability_ar00785.pdf
I am a firm believer that transcatheter valve replacement will be routine, especially for the elderly, within the next 10 years. My surgeon is leading the clinical trials at Duke using the CoreValve. He recommended the CE Perimount bovine pericardial valve for me because he is positive (from running the trial) that this type of valve replacement will be the standard for older patients and patients that have already had multiple surgeries. If I get the "average life expectancy" out of my valve I will be in my mid 60's and I have already had 2 surgeries to date. When that day comes when it is time to replace it I will weigh my options and choose the best option that will last the rest of my life regardless of the type of valve that is, but I am hoping it will be the transcatheter method.
Of course there is the choice of using a mechanical valve. Barring complications this will last you the rest of your life. ACT comes along with it but there is no guarantee you won't need to take it for other reasons if you have a tissue valve (like a-fib).
Really I would get an opinion from your surgeon on using the Ross Procedure and possibly a 2nd opinion. IMO (and I am not a medical professional) with the durability of tissue valves today, the promising results of transcatheter valve clinical trials and the advancement in mechanical valves these would be my choices. And I don't say this because my Ross Procedure didn't work out. I felt I went with the best option with the information I had at the time and it just didn't work out for me. There are many others out there that have had the RP and are doing great after many years.
