Aortic valve replacement is the most common form of heart valve surgery commonly used to treat aortic stenosis and aortic regurgitation.
At Royal Brompton and Harefield Hospitals (RB&HH), London, the experts are trialling a new type of combined surgical procedure for young and middle-aged adult patients called ROSS-PEARS which will ensure a long-lasting, excellent quality of life for these patients, without needing life-long anticoagulation medication.
A better approach for replacing aortic valves in younger patients
People with congenital heart disease often need monitoring and treatment throughout their lives, and some may need heart valve surgery in their 20s or 30s.
The ROSS procedure is an alternative way of replacing the aortic valve in younger patients with a biological valve made from a patient’s own healthy heart valve and one from a human donor.
The procedure utilises the biological similarities between the two heart valves to replace the diseased aortic heart valve with the patient’s own healthy pulmonary valve. The pulmonary valve is then replaced with a healthy valve from a donor which is cryopreserved until it is needed.
Once implanted, the pulmonary valve goes through an adaptive remodelling process, closely mimicking the function of the aortic valve it replaced. Also, as human valves are used, patients don’t need anti-coagulation medications.
Advancing the ROSS procedure
Although patients can expect excellent long-term results with the ROSS procedure, the pulmonary valve which is used to replace the diseased aortic valve can itself require replacing after 15 years.
Surgery to reinforce the aorta at the root with a synthetic support following the
ROSS procedure has been shown to reduce the need for reoperation on the pulmonary valve autograft.
Personalised external aortic root support (PEARS) is a relatively new aortic root reinforcement system. It was originally developed at RB&HH for patients with Marfan syndrome.
“By adding aortic root reinforcement with PEARS to the ROSS procedure, the experts hope to reduce the number of patients requiring reoperation on the pulmonary valve autograft.” explains consultant cardiac surgeon, Professor John Pepper, who pioneered the PEARS procedure at Royal Brompton Hospital.
• To find out more, visit: www.rbhh-specialistcare.co.uk
