What is the Ross Procedure?

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  • Written By: Debra Durkee
  • Edited By: Daniel Lindley
  • Last Modified Date: 10 February 2020
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The Ross Procedure is a surgical option for individuals who need to have the aortic valve of the heart replaced. In other procedures, the aortic valve is replaced with outside tissue; in the Ross Procedure, it is replaced by another valve in the heart, the pulmonary valve. In turn, the pulmonary valve is replaced by other types of human tissue.

The aortic valve is a section of the heart responsible for keeping the blood flowing in the right direction. Blood is brought back to the heart by the arteries, and when it is filled with oxygen again, it is pumped through the aortic valve and back to the rest of the body. If this valve is defective, blood can begin leaking backward; this will make the heart work harder.

In other types of replacement surgeries, defective valves have been replaced by the same section of either a pig's heart or a cow's heart. In these cases, there was always a chance that the body would reject the new tissue, and individuals would have to go through the surgery again. Once the new tissue was accepted, the patient would need to be on blood thinners for life as well as risk having to undergo the surgery again if the animal valve became worn out.


In the Ross Procedure, the defective valve is replaced with the pulmonary valve from the same person's heart. Ordinarily, the function of the pulmonary valve is to allow blood to flow to the lungs to become oxygenated. If this valve is healthy, it can be more efficient to replace the aortic valve with the pulmonary valve, and then in turn replace the pulmonary valve with other tissue, usually a preserved valve from an organ donor.

For most individuals that undergo the Ross Procedure, the pulmonary valve adapts well to its new role and there is less chance of a need to replace this valve again. While there may be a need to replace the new, cadaver-donated valve, replacing a pulmonary valve is a much less complicated and lower-risk procedure. This can also be beneficial for children who need to undergo surgery, as the body will heal around an aortic valve replaced with the body's own tissue. This valve will grow with the child, which is not the case with a mechanical or animal valve.

The Ross Procedure was developed by and named for Dr. Donald Ross, an English surgeon. It was first done in the 1960s, and took several decades to spread to other countries. Like similar procedures, the recovery period can be long and difficult, but the long-term prognosis is generally good.


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