D
Destinova
Thanks everyone for the input on my previous thread.
I met with Dr. David Ross at the University of Alberta Hospital today to discuss my candidacy for the Ross procedure for my surgery. He is one of the premier congenital cardiothoracic surgeons in Canada, and I am very comfortable to have both he and Dr. Rod Macarthur as my surgeons.
He feels that I am a good candidate for the Ross, but feels there may be some concern with the size of the aortic annulus. He says it is showing at around 31mm and there are potential leakage issues with the Ross for an aortic annulus greater than 27mm. He did indicate however that he has done a few with larger than 27mm and has not had any issues.
We discussed the procedure at length and he explained that his personal series of Ross procedures has been successfull because he does not push the envelope with his candidates, he only performs fairly straightforward RP's with who he feels are good candidates.
Before committing to the Ross, they would perform measurements in the OR to determine if the annulus was in fact too large, and if so would proceed with a mechanical AVR instead as a backup plan, with Dr. MacArthur performing that surgery, since they will both be present.
He has performed 37 Ross Procedures, with the 38th scheduled for this Friday. His first was in 1995. He has had only one death in the OR - and that was due to a complication not related to the RP. Of the other 36, only one has died post-op, 8 years afterwards due to a non-cardiac related illness.
The remaining 35 are all alive and well. Only one has had a reoperation, and that was for the aortic autograft. The patient had developed endocarditis and some perforations had to be repaired, the autograft was left in and is functioning fine now - so all 35 still have their full RP.
All but one pulmonary homograft was done with human pulmonary tissue as the UofA has a fairly good tissue bank. The other was human aortic tissue and is still in place with no issues.
I asked him about possible connective tissue disorders causing the pulmonary valve to be unuseable. He disputed the theory that bicuspid aortic valves were indicators of related connective tissue disorders. He went on to explain that almost all of his RP's were bicuspid AV patients such as myself and none had bicuspid PV's. *shrug*
He recommends we plan to do the surgery as a Ross, with a backup plan of doing the AV/AR replacement with a St. Jude mechanical as a backup should the annulus be too large for the PV. Even with only 37 (soon to be 38) RP's under his belt I am leaning that way myself.
He was definitely not pushing the Ross at all, and was clear the entire time that the decision is 100% mine, but he feels that between the AV/AR and Ross, it's a dead heat for which choice is the best for my situation.
I met with Dr. David Ross at the University of Alberta Hospital today to discuss my candidacy for the Ross procedure for my surgery. He is one of the premier congenital cardiothoracic surgeons in Canada, and I am very comfortable to have both he and Dr. Rod Macarthur as my surgeons.
He feels that I am a good candidate for the Ross, but feels there may be some concern with the size of the aortic annulus. He says it is showing at around 31mm and there are potential leakage issues with the Ross for an aortic annulus greater than 27mm. He did indicate however that he has done a few with larger than 27mm and has not had any issues.
We discussed the procedure at length and he explained that his personal series of Ross procedures has been successfull because he does not push the envelope with his candidates, he only performs fairly straightforward RP's with who he feels are good candidates.
Before committing to the Ross, they would perform measurements in the OR to determine if the annulus was in fact too large, and if so would proceed with a mechanical AVR instead as a backup plan, with Dr. MacArthur performing that surgery, since they will both be present.
He has performed 37 Ross Procedures, with the 38th scheduled for this Friday. His first was in 1995. He has had only one death in the OR - and that was due to a complication not related to the RP. Of the other 36, only one has died post-op, 8 years afterwards due to a non-cardiac related illness.
The remaining 35 are all alive and well. Only one has had a reoperation, and that was for the aortic autograft. The patient had developed endocarditis and some perforations had to be repaired, the autograft was left in and is functioning fine now - so all 35 still have their full RP.
All but one pulmonary homograft was done with human pulmonary tissue as the UofA has a fairly good tissue bank. The other was human aortic tissue and is still in place with no issues.
I asked him about possible connective tissue disorders causing the pulmonary valve to be unuseable. He disputed the theory that bicuspid aortic valves were indicators of related connective tissue disorders. He went on to explain that almost all of his RP's were bicuspid AV patients such as myself and none had bicuspid PV's. *shrug*
He recommends we plan to do the surgery as a Ross, with a backup plan of doing the AV/AR replacement with a St. Jude mechanical as a backup should the annulus be too large for the PV. Even with only 37 (soon to be 38) RP's under his belt I am leaning that way myself.
He was definitely not pushing the Ross at all, and was clear the entire time that the decision is 100% mine, but he feels that between the AV/AR and Ross, it's a dead heat for which choice is the best for my situation.
What a good example of studying and knowing what to ask the doctors. Sounds like you have a solid plan of attack.
