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Ross Procedure — EECC MCQ

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EasyValvular Heart DiseaseRoss ProcedureEECC

A 30-year-old man with severe aortic regurgitation due to a bicuspid aortic valve is assessed for surgical options. His aortic root is 38 mm. The surgeon discusses the possibility of a Ross procedure. What does this involve?

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Correct answer: D — Replacement of the diseased aortic valve with the patient's own pulmonary valve (autograft), with a pulmonary homograft replacing the pulmonary valve

The Ross procedure involves replacing the diseased aortic valve with the patient's own pulmonary valve (pulmonary autograft in the aortic position), and then implanting a pulmonary homograft to replace the harvested pulmonary valve. Advantages include: no need for anticoagulation (the autograft is living tissue), excellent haemodynamics, growth potential (important in children/adolescents), and low thrombogenicity. Disadvantages include: it is a technically demanding double-valve operation, risk of autograft dilatation, and the homograft will eventually degenerate requiring reintervention. The Ross procedure is recommended in younger patients (<50 years) who wish to avoid anticoagulation, performed at experienced centres.

Reference: ESC/EACTS (2025): Guidelines for the Management of Valvular Heart Disease