-andrew-
Member
I’ve not posted on this forum for a very long time, but like many others I've gained so much knowledge and confidence from reading the various discussions on here. Thanks everyone for that support!
I have seen various discussions relating to the Ross Procedure (RP) and know that people come to this forum when making the tough decision on valve type. Therefore, for young adults that are in a similar position to that which I was in 11 years ago, I’ve summarised my experience with the RP below.
In 2002 at the age of 26 I had a RP to correct a leaking, calcified bicuspid aortic valve. I had no outward symptoms before surgery other than a short TIA 2 years before the operation. The surgery was performed in the UK by a respected surgeon who had performed many RPs previously, albeit on mainly younger (as young as <1 month!) patients.
I chose the RP for a number of reasons:
1. My surgeon worked out of my local hospital (The Freeman in Newcastle, UK), only 30 miles from home, and his recommendation for me was a RP.
2. My cardiologist was also very positive and confident about the potential outcomes of RPs, to the extent that his view was that the RP could last a normal lifetime. Thanks to this forum and reviewing various online articles / papers I never allowed myself to buy into this positivity and always assumed that I would need at least 1, probably more, repeat surgeries in my lifetime. However, it was still encouraging to see a medical professional that held such a positive outlook.
3. At the time, I was not keen to take on the responsibility of managing my INR levels and taking Coumadin for life. I wanted to minimise (and ideally avoid) any type of on-going medication and the RP potentially enabled this.
4. The RP was still a relatively ‘new’ procedure and the techniques for performing it and so potentially its lifetime were still developing. I was encouraged by the potential this offered and was happy to take the associated risk of the uncertainty of a developing procedure.
5. I was (and still am) a very active person (swimming, triathlon, road & mountain biking and snowboarding). At the time I thought that choosing a mechanical valve could limit these activities. I see from various posts on this site that this would probably not have been the case.
My surgery was uneventful (as the docs say!) and I was back to cycling, running and swimming within 6 weeks. I also managed the Great North Run half marathon 6 months after my surgery (although just missed beating the 2 hour barrier, which still alludes me but mainly because I’m a poor runner – nothing to do with my heart!). I think going into the surgery in good shape really helped.
For 10 years, the RP gave me exactly what I’d hoped for and other than my 6 / 12 month check-ups, my lifestyle was completely unchanged from before surgery. For 99% of the time I gave absolutely no consideration to my heart condition and just lived a normal, healthy lifestyle. Unfortunately, as now seems to be a common outcome in some patients who’ve had the RP, my aortic root became dilated over a period of 1.5 years and a final size of 5.7 cm led to repeat surgery this year. I understand that after somewhere around 2003 – 05 (in the UK at least), this failure mechanism became more well-known and that current RPs involve supporting the root if appropriate at the time of the original surgery.
I agreed to have a valve-sparing aortic root replacement conducted by the same surgeon at the same hospital, which was conducted 3 weeks ago. Apparently, both the aortic and pulmonary valves were in good condition and the function of the aortic valve seen in the echo performed 1 week after the surgery was good. My surgeon (who admits to being an optimistic person), sees no reason why the repair will not provide me with 20-30 years of operation-free living. I’m sceptical of that but happy to try and prove him right! So far, my recovery has been easier / quicker if anything than the first surgery, but it’s still early days.
So overall, although my RP failed after only 11 years, personally I am still happy with the decision I made and even with hindsight, would make the same call now. I’m now older, more responsible (slightly) and would be happy to take on the responsibility that comes with a mechanical valve and Coumadin if / when the time comes to replace one or more of my heart valves.
For me I found it so important to do my own research and to read the negative as well as positive aspects of the various options. After discussing my thoughts with my cardiologist and surgeon, I had confidence in their recommendation and my decision and went into both surgeries with a very positive outlook.
I wish everyone the best of luck in making their decisions and hope the above has helped at least a little bit.
Best wishes,
Andrew
I have seen various discussions relating to the Ross Procedure (RP) and know that people come to this forum when making the tough decision on valve type. Therefore, for young adults that are in a similar position to that which I was in 11 years ago, I’ve summarised my experience with the RP below.
In 2002 at the age of 26 I had a RP to correct a leaking, calcified bicuspid aortic valve. I had no outward symptoms before surgery other than a short TIA 2 years before the operation. The surgery was performed in the UK by a respected surgeon who had performed many RPs previously, albeit on mainly younger (as young as <1 month!) patients.
I chose the RP for a number of reasons:
1. My surgeon worked out of my local hospital (The Freeman in Newcastle, UK), only 30 miles from home, and his recommendation for me was a RP.
2. My cardiologist was also very positive and confident about the potential outcomes of RPs, to the extent that his view was that the RP could last a normal lifetime. Thanks to this forum and reviewing various online articles / papers I never allowed myself to buy into this positivity and always assumed that I would need at least 1, probably more, repeat surgeries in my lifetime. However, it was still encouraging to see a medical professional that held such a positive outlook.
3. At the time, I was not keen to take on the responsibility of managing my INR levels and taking Coumadin for life. I wanted to minimise (and ideally avoid) any type of on-going medication and the RP potentially enabled this.
4. The RP was still a relatively ‘new’ procedure and the techniques for performing it and so potentially its lifetime were still developing. I was encouraged by the potential this offered and was happy to take the associated risk of the uncertainty of a developing procedure.
5. I was (and still am) a very active person (swimming, triathlon, road & mountain biking and snowboarding). At the time I thought that choosing a mechanical valve could limit these activities. I see from various posts on this site that this would probably not have been the case.
My surgery was uneventful (as the docs say!) and I was back to cycling, running and swimming within 6 weeks. I also managed the Great North Run half marathon 6 months after my surgery (although just missed beating the 2 hour barrier, which still alludes me but mainly because I’m a poor runner – nothing to do with my heart!). I think going into the surgery in good shape really helped.
For 10 years, the RP gave me exactly what I’d hoped for and other than my 6 / 12 month check-ups, my lifestyle was completely unchanged from before surgery. For 99% of the time I gave absolutely no consideration to my heart condition and just lived a normal, healthy lifestyle. Unfortunately, as now seems to be a common outcome in some patients who’ve had the RP, my aortic root became dilated over a period of 1.5 years and a final size of 5.7 cm led to repeat surgery this year. I understand that after somewhere around 2003 – 05 (in the UK at least), this failure mechanism became more well-known and that current RPs involve supporting the root if appropriate at the time of the original surgery.
I agreed to have a valve-sparing aortic root replacement conducted by the same surgeon at the same hospital, which was conducted 3 weeks ago. Apparently, both the aortic and pulmonary valves were in good condition and the function of the aortic valve seen in the echo performed 1 week after the surgery was good. My surgeon (who admits to being an optimistic person), sees no reason why the repair will not provide me with 20-30 years of operation-free living. I’m sceptical of that but happy to try and prove him right! So far, my recovery has been easier / quicker if anything than the first surgery, but it’s still early days.
So overall, although my RP failed after only 11 years, personally I am still happy with the decision I made and even with hindsight, would make the same call now. I’m now older, more responsible (slightly) and would be happy to take on the responsibility that comes with a mechanical valve and Coumadin if / when the time comes to replace one or more of my heart valves.
For me I found it so important to do my own research and to read the negative as well as positive aspects of the various options. After discussing my thoughts with my cardiologist and surgeon, I had confidence in their recommendation and my decision and went into both surgeries with a very positive outlook.
I wish everyone the best of luck in making their decisions and hope the above has helped at least a little bit.
Best wishes,
Andrew
