Ross Procedure (Pulmonary Autograft Procedure)

The Ross Procedure (also known as the pulmonary autograft procedure), is a highly specialized open-heart surgical option for select patients with aortic valve disease. At Michigan Medicine, the procedure is typically performed on patients younger than 55 who want to avoid future repeat open-heart surgery and the need for long-term blood thinners following surgery.

Others for whom the procedure may be beneficial include individuals who:

  • Plan to have children in the future.
  • Want to avoid additional open-heart surgeries.
  • Want to avoid complications common in surgeries where a tissue or mechanical valve is used.
  • Have undergone a previous surgical aortic valve replacement and are experiencing a failed valve.
  • Have a very small aortic valve in need of replacement.

What Is Involved in the Ross Procedure?

Illustration of two hearts side by side showing removal of damaged aortic valve, replacement of it with existing pulmonary valve and insertion of new pulmonary valve

Credit: Stephanie King

During the Ross open-heart procedure, the diseased aortic valve is removed and replaced with the patient’s own pulmonary valve. A second pulmonary valve, typically human homograft valve or occasionally animal tissue valve, is then attached where the initial pulmonary valve was removed.

Because the procedure involves significant reconstruction of the heart valves, it requires the skill of a surgeon with specialized expertise.

The Ross procedure is different from a traditional surgical aortic valve replacement (SAVR) procedure because it uses the patient’s own valve versus a bioprosthetic or tissue valve. This benefits the patient in several ways, including:

  • Eliminates the need for blood thinners after surgery.
  • Minimizes the risk of eventual valve deterioration when compared with a tissue valve.
  • Ensures compatibility.
  • Decreases the possibility of valve infection.
  • Results in a patient survival curve identical to that of a healthy individual.

Following the Ross procedure, patients may be prescribed medications such as beta blockers to control blood pressure as the pulmonary valve begins its new function as an aortic valve.

Make an Appointment

To schedule an appointment to discuss the Ross procedure or any other cardiovascular condition or treatment, contact the Michigan Medicine Cardiovascular Call Center at 888-287-1082 or visit our Make a Cardiovascular Appointment page, where you can learn what to expect when you call us.