Hello I need some information on the Ross procedure. The doctors have told me my 3 1/2 year old son needs it done. He has had a bicuspid aortic valve since birth and a balloon dilation at 9 months. There is now severe regurgitation present but he is asymptomatic. The surgeon gives him only 25% chance of the repair working then will proceed with a Ross procedure. I want to know best case senario what to expect during surgery and recovery? I need to be fully prepared.
When children have balloon dilation of a stenotic (tight) bicuspid aortic valve, then leakage of the valve is a known consequence of the procedure. Unfortunately we cannot predict who will develop severe aortic valve leakage over time, as it sounds like your son has done. Many surgeons will attempt a valvuloplasty to try to tighten up the valve and minimize the leakage, but that can only be done if there is not alot of underlying residual valve narrowing. When a plasty procedure is not feasible, then the valve needs to be replaced. We have limited options for valve replacements in young children as the valve is too small for the usual prosthetic valves. The options include a homograft valve (a preserved human valve) but these are known to deteriorate in young children within a few years. The Ross procedure removes the child's own pulmonary valve (alive) and places it in the aortic position. The advantage is that this valve can grow with the child. The disadvantages include the development of valve leakage and enlargement of the aortic root over time (often requiring another valve surgery later) and there is a need to replace the pulmonary valve with a homograft that will also need replacing at a later time. So a Ross procedure is not a final operation. there will be more to come over a lifetime. However, it is very important to preserve the function of the left ventricular pumping chamber. If your child's doctor's feel that a surgery is indicated at this time, please be sure to have them clarify what those are for you. They can also review their surgical outcomes and prepare you for the amount of time your child might spend in the hospital after surgery. Good luck,
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