title: What is the role of the Ross procedure in today's armamentarium?
abstract: The Ross procedure, which consists of replacing the aortic root with a pulmonary autograft, is the only surgery that ensures long-term viability of the aortic valve substitute. The presence of a living valve in the aortic position was theorized to translate into improved clinically relevant outcomes. This has now been confirmed by a number of recently published studies, which highlight the benefits associated with this surgery in terms of survival, quality of life, hemodynamic characteristics, and freedom from valve-related complications. Nevertheless, despite the evidence, the Ross procedure remains largely underused and has even been abandoned by a large number of groups based on some real and sometimes justifiable concerns, and a number of unfounded biases. The aim of this article is to provide a comprehensive, evidence-based review of the current literature pertaining to the Ross procedure, with an emphasis on the rationale, results, technical key points, alternatives, and future directions.
authors.affiliation: Department of Cardiac Surgery, Montreal Heart Institute, Universite de Montréal, Montreal, Québec, Canada. Electronic address: i.elhamamsy@icm-mhi.org.
authors.forename: Ismail
authors.initials: I
authors.lastname: El-Hamamsy
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Poirier
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D001021:Aortic Valve / Q000601:surgery*; D064592:Autografts; D001705:Bioprosthesis / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D011664:Pulmonary Valve / Q000601:surgery / Q000637:transplantation*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult