Author + information
- Received August 6, 2018
- Accepted August 19, 2018
- Published online November 26, 2018.
- Amine Mazine, MD, MSca,
- Ismail El-Hamamsy, MD, PhDb,∗∗ (, )@IHamamsy,
- Subodh Verma, MD, PhDc,
- Mark D. Peterson, MD, PhDc,
- Robert O. Bonow, MD, MSd,
- Magdi H. Yacoub, MD, PhDe,
- Tirone E. David, MDf and
- Deepak L. Bhatt, MD, MPHg,∗ (, )@DLBHATTMD@BrighamWomens
- aDivision of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada
- bDivision of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
- cDivision of Cardiac Surgery, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
- dDepartment of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- eImperial College London, London, United Kingdom
- fDivision of Cardiac Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
- gBrigham and Women’s Hospital Heart & Vascular Center, Harvard Medical School, Boston, Massachusetts
The ideal aortic valve substitute for young and middle-aged adults remains elusive. The Ross procedure (pulmonary autograft replacement) is the only operation that allows replacement of the diseased aortic valve with a living substitute. However, use of this procedure has declined significantly due to concerns over increased surgical risk and potential long-term failure of the operation. Several recent publications from expert centers have shown that in the current era, the Ross procedure can be performed safely and reproducibly in appropriately selected patients. Furthermore, an increasing body of evidence suggests that the Ross procedure is associated with better long-term outcomes compared with conventional aortic valve replacement in young and middle-aged adults. In this paper, the authors review the indications and technical considerations of the Ross procedure, describe its advantages and drawbacks, and discuss patient selection criteria. Finally, the authors provide a comprehensive synthesis of the current Ross published reports to enable cardiologists and surgeons to make appropriate decisions for their patients with aortic valve disease.
Dr. Verma is a recipient of a Tier 1 Canada Research Chair in Cardiovascular Surgery; and has served on the BELIEVE study steering committee. Dr. Bonow has served as Editor-in-Chief of JAMA Cardiology and editor of Braunwald’s Heart Disease for Elsevier. Dr. Bhatt has served on the advisory boards of Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; has served on the board of directors of the Boston VA Research Institute, Society of Cardiovascular Patient Care, and TobeSoft; served as chair of the American Heart Association Quality Oversight Committee; has served on data monitoring committees for the Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Cleveland Clinic, Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine, and Population Health Research Institute; has received honoraria from the American College of Cardiology (senior associate editor, Clinical Trials and News, ACC.org; vice-chair, ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim), Belvoir Publications (Editor-in-Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), HMP Global (Editor-in-Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (guest editor; associate editor), Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national coleader, funded by Bayer), Slack Publications (chief medical editor, Cardiology Today’s Intervention), Society of Cardiovascular Patient Care (secretary/treasurer), WebMD (CME steering committees); has other relationships with Clinical Cardiology (deputy editor), NCDR-ACTION Registry Steering Committee (chair), VA CART Research and Publications Committee (chair); has received research funding from Abbott, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, Eisai, Ethicon, Forest Laboratories, Idorsia, Ironwood, Ischemix, Lilly, Medtronic, PhaseBio, Pfizer, Regeneron, Roche, Sanofi, Synaptic, and The Medicines Company; has received royalties from Elsevier (editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease); has been a site coinvestigator for Biotronik, Boston Scientific, St. Jude Medical (now Abbott), and Svelte; has been a trustee for the American College of Cardiology; and has performed unfunded research for FlowCo, Merck, Novo Nordisk, PLx Pharma, and Takeda. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 6, 2018.
- Accepted August 19, 2018.
- 2018 American College of Cardiology Foundation
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