The Ross procedure: total root technique
Elbert E Williams, Ismail El-Hamamsy
Clinical vignette
A fifty-four-year-old man with a history of hypertension, hyperlipidemia and cigarette smoking presented to hospital following a syncopal episode. He reported worsening shortness of breath and dyspnea on exertion. A comprehensive workup revealed severe bicuspid aortic stenosis [mean gradient: 44 mmHg and aortic valve (AV) area: 0.62 cm2], preserved left ventricular function and nonsignificant coronary artery disease. Computerized tomography scan showed a 42 mm ascending aorta. Given his age, overall health, cardiac function, and anticipated life expectancy >15 years, a Ross procedure was planned. When performed in centers of expertise, the Ross procedure provides optimal long-term survival, hemodynamics and quality of life (1). However, the safety and long-term durability of the operation depend on various technical factors, which we aim to detail in this video.
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Publications
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Independent practice should require thoracic board certification
David H. Adams, MD, Dimosthenis Pandis, MD, Shaf Keshavjee, MD -
Propensity-Matched Comparison of the Ross Procedure and Prosthetic Aortic Valve Replacement in Adults
Ismail El-Hamamsy, MD, PhD, Nana Toyoda, MD, PhD, Shinobu Itagaki, MD, MSc, Paul Stelzer, MD, Robin Varghese, MD, Elbert E. Williams, MD, Natalia Egorova, PhD, David H. Adams, MD -
Aortic Arch Replacement: How I Teach It
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Mitral Annular Disjunction: A Contrary View
Dimosthenis Pandis, MD, MSc, Anelechi C. Anyanwu, MD, FRCS, David H. Adams, MD, FACC