Current status of the Ross procedure in aortic valve surgery

The Ross procedure represents a unique surgical concept of unrepairable diseased aortic valve replacement by patient's own pulmonary valve (pulmonary autograft). After pulmonary valve removal, the right ventricle outflow tract is reconstructed by pulmonary allograft transplantation. Pulmonary valve in aortic position (pulmonary autograft) displays excellent haemodynamic features, viability with a growth-potential (in children) and a low risk of thromboembolism and infective endocarditis unparalleled to other heart valve substitutes. Despite the advantages of a pulmonary autograft the Ross procedures arouses controversies and surgical respect due to its technical complexity and involvement of another valve into a risk of complications and potential reoperation. Renaissance of interest in Ross procedure has been caused by recent operation standardisation, knowledge of critical procedural steps and confirmation of excellent long-term results. Ross procedure performed in dedicated centres with utmost attention to technical details securing long-term durability of both the autograft and allograft is an attractive option namely for young patients with aortic valve disease.