Re: ROSS PROCEDURE

Posted By CCF CARDIO MD - DLB on March 23, 1999 at 11:27:33:

In Reply to: ROSS PROCEDURE posted by LYLE H on March 22, 1999 at 18:17:25:






The Ross Procedure has been proposed for my 19 year old daughter.  As an infant, a coarctation of the aorta was repaired.  At age 3, the aortic valve was repaired by trimming the valves.  At age 5, a great deal of scar tissue was removed from the aortic valve.  It was anticipated that the procedure would require the use of a pacemaker due to the amount of scar tissue.  This was not the case.  At age 16, the valve and coractation were both stretched with balloon treatment.  Her heart wall is now beginning to thicken.
Questions:
Are there other treatments available besides the Ross Procedure, , since it has so many complications and apparently is not endorsed by all cardiologists?
If needed, compare the various valve types (ie mechanical vs human vs pig vs bovine)  I would be interested in longevity, complications, need for anti-rejection drugs, blood thinners, etc.
If a mechanical valve is recommended, please provide a comparison of the top 3 models
Our cardiologist has mentioned that anit-rejection drugs will be required.  From reading the Forum, it appears that this might be optional.
How much risk is involved with the Ross Procedure compared to other treatment options?.
Is there a Web-link that deals specifically in the Ross Procedure.  Reference was made to one in June of 1998, but I could not find it
Thank you
Lyle H





Dear Lyle
There is controversy regarding the efficacy of the Ross procedure. My only suggestion would be that if you have it done, go to a surgeon that does a lot of them.
If a mechanical valve is placed, you need to be on blood thinners forever. These valves last for a very long time. The surgeon will decide which mechanical valve to use - you have no say in the choice of mechanical valve. Being on blood thinners is tricky if you want to get pregnant - it can be done, but requires a lot of planning and a lot of hospital visits. For a tissue valve, you do not need to be on blood thinners - some cardiologists do recommend them for a short period of time. Tissue valves will almost certainly not last for a lifetime. Your daughter can count on having another surgical procedure later. Thus, either a tissue valve or a mechanical valve has potential disadvantages. It is a difficult decision your daughter has to make. One option would be to go with a tissue valve to get her through the childbearing years, and then replace it with a mechanical valve when the time comes.
I am aware of no cardiologist who uses anti-rejection drugs after any kind of valve surgery.
Here is the Ross procedure website: http://www1.primenet.com/~carym/. I have not used it so I cannot comment on its accuracy.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.