What is the Ross procedure?
The Ross procedure is a cardiac surgery that replaces a diseased aortic valve with the patient's own pulmonary valve (autograft), then replaces the pulmonary valve with a donor valve (homograft). It is primarily performed in young and middle-aged adults (ages 20-55) because the autograft grows with the patient, does not require blood-thinning medication, and can last 20+ years.
The complete answer.
The Ross procedure is technically demanding and should only be performed by surgeons with significant experience — outcomes are strongly volume-dependent. At expert centers, operative mortality is 1-2% with excellent 20-year survival. The procedure is particularly advantageous for young women planning pregnancy (avoiding warfarin), athletes (no anticoagulation), and patients who refuse long-term medication. However, it converts a single-valve problem into a two-valve problem, and 15-20% of patients may need reoperation on the pulmonary homograft within 20 years.
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