Ross Procedure in Adults for Cardiologists and Cardiac Surgeons: JACC State-of-the-Art Review

Amine Mazine, Ismail El-Hamamsy, Subodh Verma, Mark D. Peterson, Robert O. Bonow, Magdi H. Yacoub, Tirone E. David, Deepak L. Bhatt*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

132 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2761-2777
Number of pages17
JournalJournal of the American College of Cardiology
Issue number22
StatePublished - Dec 4 2018


  • Ross procedure
  • aortic valve replacement
  • pulmonary autograft
  • young adults

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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