Ross procedure: Difference between revisions
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The '''Ross<nowiki></nowiki> procedure''' (or '''pulmonary autograft''') is a [[cardiac surgery]] operation where a diseased [[aortic valve]] is replaced with the person's own [[pulmonary valve]]. A pulmonary [[allograft]] (valve taken from a [[cadaver]]) is then used to replace the patient's own pulmonary valve. Pulmonary autograft replacement of the aortic valve is the operation of choice in infants and children, but its use in adults remains controversial.<ref name="Yacoub 2006">{{cite journal |vauthors=Yacoub M, Klieverik L, Melina G, Edwards S, Sarathchandra P, Bogers A, Squarcia U, Sani G, van Herwerden L, Takkenberg J |title=An evaluation of the Ross operation in adults |journal=J Heart Valve Dis |volume=15 |issue=4 |pages=531–9 |year=2006 |pmid=16901050}}</ref> |
The '''Ross<nowiki></nowiki> procedure''' (or '''pulmonary autograft''') is a [[cardiac surgery]] operation where a diseased [[aortic valve]] is replaced with the person's own [[pulmonary valve]]. A pulmonary [[allograft]] (valve taken from a [[cadaver]]) is then used to replace the patient's own pulmonary valve. Pulmonary autograft replacement of the aortic valve is the operation of choice in infants and children, but its use in adults remains controversial.<ref name="Yacoub 2006">{{cite journal |vauthors=Yacoub M, Klieverik L, Melina G, Edwards S, Sarathchandra P, Bogers A, Squarcia U, Sani G, van Herwerden L, Takkenberg J |title=An evaluation of the Ross operation in adults |journal=J Heart Valve Dis |volume=15 |issue=4 |pages=531–9 |year=2006 |pmid=16901050}}</ref> |
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The Ross procedure is named after Dr. [[Donald Ross (surgeon)|Donald Ross]] — a pioneer in cardiac surgery in the [[United Kingdom|UK]] — who proposed the procedure in 1962<ref name="Ross 1962">{{cite journal | author = Ross D | title = Homograft replacement of the aortic valve | journal = Lancet | volume = 2 | issue = 7254| pages = 487 | year = 1962 | pmid = 14494158 | doi = 10.1016/S0140-6736(62)90345-8}}</ref> and first performed it in 1967.{{cn|date=November 2021}} |
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==Advantages and disadvantages== |
==Advantages and disadvantages== |
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The pros and cons of this procedure are:{{cn|date=February 2021}} |
The pros and cons of this procedure are:{{cn|date=February 2021}} |
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===Advantages=== |
===Advantages=== |
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* Freedom from [[thromboembolism]] without the need for [[anticoagulation]]. |
* Freedom from [[thromboembolism]] without the need for [[anticoagulation]]. |
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Homografts (aortic or pulmonary) should be the replacement of choice; no other valve performed as well in the pulmonary position. Many homograft valves are sterilized with [[ethylene oxide]] or [[irradiation]]—methods recognized to have deleterious effects on valve performance. The results of the pulmonary autograft procedure are likely to be superior with the use of fresh homograft valves.<ref name="Chambers 1997"/> Today, cryopreservation is the method of choice for homograft preservation.{{cn|date=February 2021}} |
Homografts (aortic or pulmonary) should be the replacement of choice; no other valve performed as well in the pulmonary position. Many homograft valves are sterilized with [[ethylene oxide]] or [[irradiation]]—methods recognized to have deleterious effects on valve performance. The results of the pulmonary autograft procedure are likely to be superior with the use of fresh homograft valves.<ref name="Chambers 1997"/> Today, cryopreservation is the method of choice for homograft preservation.{{cn|date=February 2021}} |
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The Ross procedure is named after [[Donald Ross (surgeon)|Donald Ross]] who first performed it in 1967.<ref name="Ross 1962">{{cite journal | author = Ross D | title = Homograft replacement of the aortic valve | journal = Lancet | volume = 2 | issue = 7254| pages = 487 | year = 1962 | pmid = 14494158 | doi = 10.1016/S0140-6736(62)90345-8}}</ref><ref>{{cite book |last1=Treasure |first1=Tom |editor1-last=Silverman |editor1-first=Mark E. |editor2-last=Fleming |editor2-first=Peter R. |editor3-last=Hollman |editor3-first=Arthur |editor4-last=Julian |editor4-first=Desmond G. |editor5-last=Krikler |editor5-first=Dennis M. |title=British Cardiology in the 20th Century |date=2000 |publisher=Springer |isbn=978-1-4471-1199-3 |page=206|url=https://books.google.com/books?id=eNrRBgAAQBAJ&pg=PT206 |language=en |chapter=16. Cardiac surgery}}</ref> |
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==See also== |
==See also== |
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Revision as of 15:52, 5 February 2022
| Ross procedure | |
|---|---|
 Ross procedure | |
| Other names | Pulmonary autograft |
| ICD-9-CM | 35.21 |
The Ross procedure (or pulmonary autograft) is a cardiac surgery operation where a diseased aortic valve is replaced with the person's own pulmonary valve. A pulmonary allograft (valve taken from a cadaver) is then used to replace the patient's own pulmonary valve. Pulmonary autograft replacement of the aortic valve is the operation of choice in infants and children, but its use in adults remains controversial.[1]
Advantages and disadvantages
The pros and cons of this procedure are:[citation needed]
Advantages
- Freedom from thromboembolism without the need for anticoagulation.
- The valve grows as the patient grows (i.e., children).
- Favourable hemodynamics.
- No foreign material present in the valve.
Disadvantages
- Single-valve disease (aortic) treated with a two-valve procedure (aortic and pulmonary).
Pulmonary valve replacement
One of the main objections to the Ross-Yacoub procedure is the genesis of pulmonary valve disease in addition to aortic valve disease. Proponents have argued that biological valves implanted in the pulmonary position would be slow to develop dysfunction, and any dysfunction would be well tolerated due to the lower pressures in the right side of the heart. Survival of homografts in the pulmonary position is good (20-year freedom from reoperation of 80%), and homograft dysfunction is infrequently implicated in the observed morbidity and mortality.[2]
Homografts (aortic or pulmonary) should be the replacement of choice; no other valve performed as well in the pulmonary position. Many homograft valves are sterilized with ethylene oxide or irradiation—methods recognized to have deleterious effects on valve performance. The results of the pulmonary autograft procedure are likely to be superior with the use of fresh homograft valves.[2] Today, cryopreservation is the method of choice for homograft preservation.[citation needed]
History
The Ross procedure is named after Donald Ross who first performed it in 1967.[3][4]
See also
References
- ^ Yacoub M, Klieverik L, Melina G, Edwards S, Sarathchandra P, Bogers A, Squarcia U, Sani G, van Herwerden L, Takkenberg J (2006). "An evaluation of the Ross operation in adults". J Heart Valve Dis. 15 (4): 531–9. PMID 16901050.
- ^ a b Chambers J, Somerville J, Stone S, Ross D (1997). "Pulmonary autograft procedure for aortic valve disease: long-term results of the pioneer series". Circulation. 96 (7): 2206–14. doi:10.1161/01.cir.96.7.2206. PMID 9337191.
- ^ Ross D (1962). "Homograft replacement of the aortic valve". Lancet. 2 (7254): 487. doi:10.1016/S0140-6736(62)90345-8. PMID 14494158.
- ^ Treasure, Tom (2000). "16. Cardiac surgery". In Silverman, Mark E.; Fleming, Peter R.; Hollman, Arthur; Julian, Desmond G.; Krikler, Dennis M. (eds.). British Cardiology in the 20th Century. Springer. p. 206. ISBN 978-1-4471-1199-3.
External links
- Cardiac Surgery in the Adult - Pulmonary autograft
