The Christ Hospital Heart & Vascular Institute Offers Access to Ross Procedure for Active Heart Failure Patients Age 60 and Under

The Ross procedure has historically been underutilized in adults, however, recent extensive data shows it is ideal for younger adults and can uniquely provide a normal lifespan without the use of blood thinners.

The Christ Hospital Heart & Vascular Institute continues to lead the way in caring for patients with aortic valve disease by offering the Ross procedure, an aortic valve replacement technique to improve the quality of life for adults 60 years or younger.

"Standard surgical procedure to correct aortic valve disease involves implanting a mechanical (metal) valve that requires the patient to be on a blood thinner for the rest of their life," explained Dr. J. Michael Smith, Medical Director of The Christ Hospital’s Cardiovascular and Mitral Valve Surgery Program. “The Ross procedure is the only valve operation that gives you a normal life span without the use of blood thinners.”

A mechanical valve prohibits most rigorous activities due to the increased likelihood of bleeding from the required anticoagulants. Alternatively, a pig or cow valve may be implanted as a replacement valve, and does not require blood thinners, but the lifespan is limited and therefore less suitable for younger adults.

The Ross procedure—developed in the 1960s by Donald Ross, a British surgeon—uses a patient’s own pulmonary valve in place of their diseased aortic valve. The pulmonary valve is then replaced with a cadaver human pulmonary valve and, because there is no rejection or foreign object response from the body, no blood thinners are necessary.

Dr. Smith, a world-famous heart surgeon, founded the valve program at The Christ Hospital and has performed well over 100 Ross procedures to date. “I first learned the procedure from Dr. Ross just after my medical training, at a course he offered in the United States,” he said. “Then I worked with a surgeon at Yale who did adult Ross procedures, so I performed the operation early on in my career.”

“I think many people believe the Ross procedure is only for children,” said Dr. Smith, who explained that while the surgery was originally developed for that purpose, recent extensive data shows it is an ideal operation for adults. In particular, he said it is especially suited to those patients with an active lifestyle and for whom the use of long-term blood thinners would be limiting.

“This procedure is optimal for patients under 50,” said Dr. Smith, who personally will consider the Ross for patients up to age 60. “Once you are in your 70s, the replacement pulmonary valve—which handles much less volume in the heart—is not strong enough to handle the higher pressure and function as the aortic valve.”

Incidents of reoperations for a Ross procedure over a period of 25 years are only about 5%, which is much lower than that of a mechanical valve and significantly lower than a pig or a cow valve. For younger adults, Dr. Smith said the Ross can be an ideal solution and a "once-in-a-lifetime" procedure.

Thousands of patients from Cincinnati and beyond visit The Christ Hospital annually for heart care. To schedule an appointment, call 513-206-1180 for availability at The Christ Hospital's Heart & Vascular locations throughout the Tristate.

About The Christ Hospital Health Network The Christ Hospital Health Network is an acute care hospital located in Mt. Auburn, with a remote hospital location in Liberty Township, five ambulatory outpatient centers, and dozens of offices conveniently located throughout the region. More than 1,300 talented physicians and more than 6,000 dedicated team members support the Network. Its mission is to improve the health of the community and to create patient value by providing exceptional outcomes and the finest experiences, all in an affordable way. The Network has been recognized by U.S. News & World Report as the #1 hospital in the Cincinnati Region and awarded Healthgrades “America’s 50 Best Hospitals” for being in the top 1% in the nation for providing the highest clinical quality year after year. It is also a Press Ganey Guardian of Excellence Award recipient, which recognizes top-performing healthcare organizations that achieve the 95th percentile or above of performance in patient experience. The Christ Hospital is among a select number of hospitals in the nation to be awarded Magnet® recognition for nursing excellence. For more than 130 years, The Christ Hospital has provided compassionate care to those it serves.