The Ross Procedure in Children with Congenital Heart Disease
Aortic valve disease accounts for approximately 5% of all congenital heart defects in children. Choosing the optimal valve replacement in this population is challenging, as it must ensure durability, accommodate growth, and minimize the need for long-term anticoagulation. Biological valves do not re...
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MDPI AG
2025-05-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/5/186 |
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| author | Nabil Dib Nancy Poirier Ismail Bouhout Paul Khairy |
| author_facet | Nabil Dib Nancy Poirier Ismail Bouhout Paul Khairy |
| author_sort | Nabil Dib |
| collection | DOAJ |
| description | Aortic valve disease accounts for approximately 5% of all congenital heart defects in children. Choosing the optimal valve replacement in this population is challenging, as it must ensure durability, accommodate growth, and minimize the need for long-term anticoagulation. Biological valves do not require anticoagulation but lack durability and growth potential, leading to frequent reoperations. Mechanical valves offer longevity but necessitate lifelong anticoagulation and do not grow with the child. Among the available surgical options, the Ross procedure has emerged as a preferred approach due to its favorable hemodynamic performance, growth potential, and freedom from anticoagulation. First described in 1967, this technique involves replacing the diseased aortic valve with a pulmonary autograft and reconstructing the right ventricular outflow tract using a human or non-human valve substitute. Despite its advantages, the procedure is technically demanding, has a considerable learning curve, and transforms a single-valve pathology into a bivalvular condition. This narrative review provides an updated perspective on the Ross procedure in children, focusing on long-term survival, reoperation rates, and the role of percutaneous valve replacement in delaying surgical reintervention. By synthesizing the latest evidence, we aim to clarify the current standing of the Ross procedure as a durable and effective solution for pediatric aortic valve disease. |
| format | Article |
| id | doaj-art-322f5ed46b524399bb9ca0a10aa4e971 |
| institution | DOAJ |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-322f5ed46b524399bb9ca0a10aa4e9712025-08-20T03:14:35ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-05-0112518610.3390/jcdd12050186The Ross Procedure in Children with Congenital Heart DiseaseNabil Dib0Nancy Poirier1Ismail Bouhout2Paul Khairy3Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, CanadaDivision of Cardiac Surgery, Department of Surgery, Sainte-Justine Hospital, Université de Montréal, Montreal, QC H3T 1C5, CanadaDivision of Cardiac Surgery, Department of Surgery, Sainte-Justine Hospital, Université de Montréal, Montreal, QC H3T 1C5, CanadaDepartment of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, CanadaAortic valve disease accounts for approximately 5% of all congenital heart defects in children. Choosing the optimal valve replacement in this population is challenging, as it must ensure durability, accommodate growth, and minimize the need for long-term anticoagulation. Biological valves do not require anticoagulation but lack durability and growth potential, leading to frequent reoperations. Mechanical valves offer longevity but necessitate lifelong anticoagulation and do not grow with the child. Among the available surgical options, the Ross procedure has emerged as a preferred approach due to its favorable hemodynamic performance, growth potential, and freedom from anticoagulation. First described in 1967, this technique involves replacing the diseased aortic valve with a pulmonary autograft and reconstructing the right ventricular outflow tract using a human or non-human valve substitute. Despite its advantages, the procedure is technically demanding, has a considerable learning curve, and transforms a single-valve pathology into a bivalvular condition. This narrative review provides an updated perspective on the Ross procedure in children, focusing on long-term survival, reoperation rates, and the role of percutaneous valve replacement in delaying surgical reintervention. By synthesizing the latest evidence, we aim to clarify the current standing of the Ross procedure as a durable and effective solution for pediatric aortic valve disease.https://www.mdpi.com/2308-3425/12/5/186aortic valve diseaseRoss procedurecongenital heart diseasepediatric cardiology |
| spellingShingle | Nabil Dib Nancy Poirier Ismail Bouhout Paul Khairy The Ross Procedure in Children with Congenital Heart Disease Journal of Cardiovascular Development and Disease aortic valve disease Ross procedure congenital heart disease pediatric cardiology |
| title | The Ross Procedure in Children with Congenital Heart Disease |
| title_full | The Ross Procedure in Children with Congenital Heart Disease |
| title_fullStr | The Ross Procedure in Children with Congenital Heart Disease |
| title_full_unstemmed | The Ross Procedure in Children with Congenital Heart Disease |
| title_short | The Ross Procedure in Children with Congenital Heart Disease |
| title_sort | ross procedure in children with congenital heart disease |
| topic | aortic valve disease Ross procedure congenital heart disease pediatric cardiology |
| url | https://www.mdpi.com/2308-3425/12/5/186 |
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