Ross procedure complete

[Chuck C]

This forum is a great resource but it should only make up ( likely small ) part of the decision making process.

So true. It is important for folks to understand that they should receive input from all directions, but ultimately, they must decide the course that is best for them.

I also notice that some of the information being shared about the Ross is quiteout of date here.

Would you be so good to share the information that you have, which is more current, so as to help others?

 

[Jmprosser.lab]

Agree with this all strongly! A lot of the Ross information used in discussions on this forum is dated. There’s some good info, as well! This forum is a really good SUPPLEMENTAL resource. But nobody here is a heart surgeon and they don’t know the specifics of your situation. Valvereplacement.org is often labeled as being very “pro mechanical valves”, and there is indeed a lot of good info on that here!! Dr Hamamsy and a few of the Cleveland Clinic cardios/surgeons have some really good literature and videos on Ross and it’s increasing viability.

 

[Superman]

Would you be so good to share the information that you have, which is more current, so as to help others?

I’m intrigued as well. Do they no longer move the pulmonary valve to the aortic position and replace the pulmonary valve with a bio prosthesis? Has the pulmonary valve gone through significant evolutionary changes in the last 40 years that make it function better and longer in the aortic position?

That’s really the only thing people seem to have against it. Taking a one valve problem and making a two valve problem out of it. Although if they’ve changed this, I don’t know that they can continue to call it a Ross Procedure.

Also, asking someone a year or five out from surgery how it’s going isn’t very meaningful in the context of 15 - 20 plus year issues that will or may come up. Almost everyone (with some exceptions) is doing fine less than five years out, no matter what option they chose. 19 years out and I had to have a second open heart due to an aneurysm. And I went mechanical the first time. Nobody knows when or if that boogeyman may strike.

 

[PAN]

A few months back I did upload a couple of papers. Accurate information is not always presented here and the specific points made were made over a considerable period of time.. It is not limited to the Ross. Details around mechanical valves and ACT are not always accurate either. So the discussions go on

Although they will fit a prosthetic valve in the pulmonary position that is not how the Ross was intended and if I'm not mistaken there is some data to support not doing that. Interestingly if a pulmonary homograft starts to fail the off ramp is now a trans-catheter pulmonary prosthetic.

Maybe it is a personal thing. All Ross operations are not equal. All Ross techniques deployed are not the same. At times I think an appreciation for the evolution of the procedure is missed and the prognosis for Ross patients generalised from the 60s through to 2022. The "progress" while intriguing for some is an absolute stop sign for others, completely get that as its continuous data collection. There are other examples of just wrong information as you'd expect in a place this busy. As I said, not just limited to Ross discussion.

Stress test completed today. Tough going at the end.. Let rehab commence

P

 

[pellicle]

Good morning

ahh, those papers. Yes I read them (dunno about Chuck). I would not call what was contained there anything "new" or "revolutionary". I'm of the vew that you'll get at least 15 good years from The Ross and after that I'll (either) be dead (or not reading / replying here) by then anyway.

Not that me knowing the outcomes makes any difference.

Stress test completed today. Tough going at the end.. Let rehab commence

I feel that rehab will undoubtedly be a good experience ... onward and upward.


Best Wishes.

 

[spartangator]

@PAN, all the best with rehab. I found that super fruitful in terms of regaining confidence and understanding what progress would look like. Onward and upward, as @pellicle says. Here's to loads of progress!

 

[Raoul]

Hi, good to read your story. I am getting my ross done half december.
People asking what is diffirent then before. My docter told me that they work with the valve to make it stronger before replacing and so it can not diolate. That is a new technique and make the valve function at least 25 years or longer, also because of this technique it can be replaced thrue the vane in the future (and not a openheart operation). I am getting my done in the Netherlands. I am 45 years old and have no others health issues. I am scared but also confident it will work out well.

 

[pellicle]

That is a new technique and make the valve function at least 25 years or longe

I'd look them in the eye and ask for specific details.
I'd also ask why damage the other valve when you can out a homograft in the aortic position in the first place and get exactly the same benefits as the Ross without causing injury to the other valve.

RESULTS:
For all cryopreserved valves, at 15 years, the freedom was
* 47% (0-20-year-old patients at operation),
* 85% (21-40 years),
* 81% (41-60 years) and
* 94% (> 60 years).

So as it happened I was part of the 21-40 group

 

[AZATADINE]

I'd look them in the eye and ask for specific details.
I'd also ask why damage the other valve when you can out a homograft in the aortic position in the first place and get exactly the same benefits as the Ross without causing injury to the other valve.

I've often wondered about the homograft and why it isn't offered more as an option? Is it just down to supply or does a homograft have flaws that, say a tissue prosthetic for instance, doesn't have? Same for Ross, why take the risk of involving 2 native valves rather than use a homograft?

 

[Raoul]

The homograft is in a place where it doesnt have to work as hard as in the aortic valve place. So it will last longer. The replaced valve will put in a stend before it will be placed in the aortic place (thats the new technique. So it is impossible to expand. The stend will also be used for my aneurysm. So its 2 in 1.
The normal ross wasnt placed in a stend so it will dialate after a while because of the pressure so this version is the improved ross

 

[pellicle]

The homograft is in a place where it doesnt have to work as hard as in the aortic valve place. So it will last longer.

But your pulmonary is in a place it wasn't intended for and will work harder. So why not put a homograft aortic valve in the aortic position and leave the pulmonary (which is not diseased) alone? This is a sincere question.

Have you looked into Arnold Schwarzeneggers results?

After three surgeries in my life I've still got the pulmonary working fine.

 

[pellicle]

I've often wondered about the homograft and why it isn't offered more as an option

I can only speculate, candidates would seem to be

• Availablity
• tissue typing (HLA)
• Risk of disease transfer

Which I anticipate is why we use tissue or mechanical in the main.

I have some questions about where Cryolife is sourcing it's homograft pulmonary valves from (perhaps lower demand?) and then promoting a manufactured prosthesis for the pulmonary position of the patient...

 

[Raoul]

But your pulmonary is in a place it wasn't intended for and will work harder. So why not put a homograft aortic valve in the aortic position and leave the pulmonary (which is not diseased) alone? This is a sincere question.

Have you looked into Arnold Schwarzeneggers results?

After three surgeries in my life I've still got the pulmonary working fine.

The pressure from the aortic will make the homograft last shorter.
The own tissue valve is the best and strongest option between biological and homograft (not mechanical with is stronger ofcourse).
The diolation was a problem and the reason the hospitals stoped doing it.
My surgeon (with others surgeons in the world), believed that the own tissue valve had so mutch advantages.
The main problem was the diolation witch happend with alot of times, with this new technique that is impossible.
He have done it for many years now and still with good results.

 

[pellicle]

Hi

The pressure from the aortic will make the homograft last shorter.

well, if you checked the data from my cited source it shows that a homograft aortic valve (from someone else) lasted at least as long as a Ross Autograft (of your pulmonary valve placed into your aortic position).

The own tissue valve is the best and strongest option between biological and homograft

well I don't see any data to support that ... nor have you provided any ... but really I don't mind because I will likely be dead when you develop problems with both valves eventually

The diolation was a problem and the reason the hospitals stoped doing it.

I'm unsure what you're talking about there

My surgeon (with others surgeons in the world), believed that the own tissue valve had so mutch advantages.

and yet inexplicably the vast majority of surgeons world wild (even in the USA alone) don't share that view ... odd isn't it

The main problem was the diolation witch happend with alot of times, with this new technique that is impossible.

could you at least provide some description of this new technique, because I'd like to understand it.

Just make sure you are making sound decisions based on data, not decisions of faith based on anxieties of a desire to avoid anticoagulation (for reasons which may be wrong or invalid).

Best Wishes

 

[Raoul]

Hi



well, if you checked the data from my cited source it shows that a homograft aortic valve (from someone else) lasted at least as long as a Ross Autograft (of your pulmonary valve placed into your aortic position).




well I don't see any data to support that ... nor have you provided any ... but really I don't mind because I will likely be dead when you develop problems with both valves eventually



I'm unsure what you're talking about there



and yet inexplicably the vast majority of surgeons world wild (even in the USA alone) don't share that view ... odd isn't it



could you at least provide some description of this new technique, because I'd like to understand it.

Just make sure you are making sound decisions based on data, not decisions of faith based on anxieties of a desire to avoid anticoagulation (for reasons which may be wrong or invalid).

Best Wishes

I am sorry but i am not an investor and dont have that data.
Somebody asked what is new with the ross prucedure.
And that is that they secure the valve so it can not extand.

 

[pellicle]

And that is that they secure the valve so it can not extand.

That was me and you didn't answer me.

You are however an investor, you are investing your life and your future. Should you not do due dilligence into that investment with proper background research?

Ultimately, it doesn't matter to me if you aren't concerned with facts, and expansion is not the primary mode of failure, its calcification iirc.

Best wishes

 

[Raoul]

I am sorry but dont understand. You asked what is new about it and i explaned that they make the valve stronger so it will not expand.
Thats about it,

Best wishes to you too