Ross Procedure Problems?!!

[RossGurlie]

I have heard from several people there have been reports on the internet saying doctors have been finding problems with the Ross Procedure, especially in BAV patients. I had a BAV along with aortic stenosis, regurgitation, insufficiacy (sp?), and leakage. Should I be worried about this? What are these problems??

 

[delvalle6]

well, guess I have another question for the docs! My son has Aortic Stenosis, Bicuspid valve, regurgitation, insufficiency and ventricular enlargement due to leakage. They are talking about the Ross procedure for him. I have calls into some of the top cardiologists around the US and a list of questions- I will ask this one and if I get an answer- when I get an answer, I will post it. Thank you for posting this.

 

[RossGurlie]

Thanks!

Thanks!

Hey, that'll be cool! Tell me how your son does!! Seems like we have a lot in common!!

 

[OldManEmu]

Ross

Ross

RossGurlie don't stress. If you were properly evaluated as a candidate for a Ross before surgery you shouldn't have anything more to worry about than anyone that receives a tissue valve, infact it would be less because at your age they would last <10 years. I was much older than you at 41 at the time of my surgery and I was prepared to have a Ross unfortunately events conspired that this wasn't possible and I chose a tissue valve instead.

 

[mbfleth]

RossGurlie,

I just had my 3yr Ross check up and brought this up.
To paraphrase my Doctors response...
The Ross may be performed on ideal candidates only. One of the problems with BAV is insufficiency, stenosis and regurgitation. When blood flow leaving the heart is obstructed through narrowing of the valve, the heart muscle becomes larger as it fights to push the blood through. Just like arm muscles become larger through weight lifting. This is called an enlarged heart. Enlarged is not good, but not a counterindication to the Ross on it's own. Most of us had enlarging of the muscle prior to surgery. When the enlarging becomes bad for a Ross is when the aortic root (or the place where the valve fits into the heart) becomes enlarged.
For example, if the normal valve root were the size of a quarter but due to undetected valve disease the heart enlarged and the aortic root became deformed to the size of a half-dollar or silver dollar, the pulmonary autograft would not fit properly. The surgeon would need to stretch the pulmonary valve to fit the extended opening of the aorta. This is where problems with the Ross may occur. You have heard of root embolisims due the stretched root becoming weak under the pressure of blood flow.
I would agree with OldManEmu, your heart has been monitored and under care prior to your surgery. I am sure that the Ross Procedure was only suggested since you were an ideal candidate.

Delvalle6,
Ask if your son can have the standard trans-thorasic echo AND the "TEE" trans-esophogeal echo prior to making the final decision. The TEE is performed by putting the ultrasound device down the esophogus (your son will be asleeep). This provides the best close up picture of the aortic root and the pulmonary valve for measurement purposes. If he is an ideal candidate, the Ross will give him the greatest quality of life.

 

[Karlynn]

I have heard from several people there have been reports on the internet saying doctors have been finding problems with the Ross Procedure, especially in BAV patients. I had a BAV along with aortic stenosis, regurgitation, insufficiacy (sp?), and leakage. Should I be worried about this? What are these problems??

Judging from where you had your surgery, I'm guessing that they had to be pretty darn certain you were a good candidate or they would not have done the Ross for you.

You are now in the same position that we all are after our surgeries. You live your life to the fullest, assume that everything is going to be fine and deal with anything else that comes up when it comes up and try not to worry about the "what ifs".

By the way, nice to see your avatar picture. You're a beautiful young lady!

 

[sylviayasgur]

hi,
mark b.,
i hate to cause trouble here, but i am looking at joey's surgery report (because i wanted to confirm what i thought the surgeon had told me... thought i might be mistaken, but no...) and it says that the diameter of joey's aortic annulus measured 29 mm, while his pulmonary valve had a diameter of just over 25 mm. (due to poststenotic aortic dilation). this required "extensive tailoring". i had remembered dr.stelzer explaining, in our consult with him, that the valves may not fit exactly right and that he might have to do some "tailoring to the fit".
i imagine he was prepared for this after having done so many rosses. he was bound to have run into this at one point.

i am sure that many surgeons who choose to do mostly rp's (and have done numerous, as with dr. stelzer), have seen just about anything that can go right and can go wrong.

either way, things can go right and wrong with other valves as well. it's a personal choice, the valve and the surgeon.
in the end, it saves lives, even if _worst case scenario_ it needs to be redone.

didn't mean to be bossy here, just thought i'd add some important info.

rossgurlie,
this can be an additional question to ask the surgeon...what if they don't fit exactly right?

hope this bit helped.
stay well,
sylvia