Ross Procedure

The aortic valve controls the unidirectional flow of blood from the heart to the entire body. Diseases that cause narrowing (aortic stenosis) and leaking (aortic regurgitation) of the aortic valve decreases the function of the left ventricle and cardiac output, and increases the risk for congestive cardiac failure and death. The Ross procedure is a technique used to treat the diseased aortic valve and prevent further damage to the heart. The procedure involves replacing the diseased aortic valve with your pulmonary valve, which controls the unidirectional flow of blood from the heart to the lungs for purification. This is also called a valve switching procedure as the patient’s own pulmonary valve is used to replace the diseased aortic valve.


The procedure is performed under the effect of general anaesthesia. During this open heart procedure, the heart’s function of pumping blood is taken over by a heart-lung machine. Your doctor introduces medication to temporarily stop your heart from beating. An electrocardiogram is used to continuously monitor your heart rate and rhythm throughout the procedure.

Your surgeon makes an incision in the middle of the chest and separates the breastbone to gain access to the heart. The pulmonary valve is excised. The damaged aortic valve is carefully removed and replaced with your own pulmonic valve. A pulmonary valve taken from a human donor is then placed into the pulmonic position. The heart is disconnected from the heart-lung machine and its function resumed. The breast bone is brought together and the chest incision is closed with sutures.

Post-operative care

After the procedure, you are moved to the cardiovascular intensive care unit, and your heart rate, rhythm and vital signs are closely monitored. You may experience numbness, itching and tingling, which will subside after a few days. Your doctor will prescribe medication to relieve pain, reduce discomfort and improve mobility. Scars will fade within 3 to 6 months. You should include a balanced diet to promote healing and improve your strength after the surgery. Your physical therapist may suggest a home walking program and physical exercise to improve flexibility, circulation and muscle tone. Avoid lifting heavy objects, pulling or pushing for a few months after the surgery. Inform your doctor if you experience high fever, shortness of breath, irregular heartbeats, or swollen feet and ankles.

Risks and complications

As with any surgery, the Ross procedure may involve certain risks and complications. They include:

  • Bleeding and infection
  • Stroke, heart attack
  • Breathing problems
  • Irregular heartbeats or death

Advantages and disadvantages

The advantages of the Ross procedure include:

  • Improved performance of the patients’ pulmonary valve in the aortic position
  • Superior blood flow with reduced wear and tear of the heart
  • Anti-coagulants not necessary
  • Less chance for infection

The disadvantages of the Ross procedure include:

  • Complex surgery
  • Follow-ups required for both aortic and pulmonary valves