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Ross Procedure

The Ross procedure, also known as the switch procedure, is a cardiac surgery in which the patient's pulmonary valve is used to replace the diseased aortic valve. The pulmonary valve is then replaced with a pulmonary homograft.

The Ross Procedure is very effective at treating damaged aortic valves. The aortic valve handles all the blood being pumped back out to the body. The pulmonary valve is similarly shaped.

After the pulmonary valve is moved into the aortic valve position, it can continue to grow normally in a child who is not fully grown. It can also handle the high blood flow volume from the lower pumping chamber out to the body. There is generally no need for long-term medication.

Why choose Presbyterian for your Ross procedure?

Presbyterian Heart and Vascular Care has the only pediatric and congenital cardiothoracic surgery team in New Mexico. Their team uses some of the most advanced techniques to perform this procedure. These techniques can improve recovery time, reduce complications and provide a quicker return to daily activities.

Who is eligible for a Ross procedure?

The Ross procedure is usually performed on patients younger than 50 who want to avoid taking long-term anticoagulant medications after surgery. The Ross procedure is for patients who have:

  • Aortic valve disease.

  • Endocarditis in the valve.

  • Left ventricular outflow of blood.

  • Aortic valve disease in children with congenital aortic stenosis (most common reason).

  • Some form of leaking of the aortic valve that causes blood to flow in the reverse direction.

  • Females who want to have children in the future but have bicuspid aortic valve defect and or a small aortic annulus.

You or your child's healthcare provider may want some extra tests before the surgery. These might include:

  • Chest X-ray.

  • Blood tests to check general health.

  • Electrocardiogram to check the heart rhythm.

  • Echocardiogram to look at the heart and blood flow through the heart.

  • Cardiac catheterization to better look at the coronary blood vessels or to measure the pressures in the heart and lungs

What conditions can be treated with a Ross procedure?

The Ross procedure can ease the symptoms of aortic stenosis. These symptoms include:

  • Fatigue.

  • Chest pain.

  • Problems feeding or growing.

  • Rapid or distressed breathing.

Newborns with aortic valve problems are often very ill. The Ross procedure decreases how hard the heart has to work. It also improves blood flow out to the body. Some children need treatment for aortic stenosis if they have too much pressure in the left ventricle, even if they don't yet have symptoms.

The Ross procedure is not the only treatment for aortic stenosis. Balloon valvotomy is often the first treatment. It is a less invasive procedure that helps open up the valve. But it often doesn't work permanently. It also may lead to a leaky valve.

One advantage of the Ross procedure is that the valve can grow with the child. The child will not need a future replacement.


How do I prepare for a Ross procedure?

You or your child should not eat or drink anything after midnight before the day of the surgery. Your child may need to stop taking any medicines beforehand.

Talk with you or your child’s healthcare provider about what to expect during the surgery.

What should I expect during my Ross procedure?

  • You or your child will get anesthesia before the surgery starts. You or your child will sleep deeply and feel no pain during the operation.

  • The procedure generally takes several hours.

  • The surgeon will make an incision down the middle of the chest. To reach the heart, the surgeon will separate the breastbone.

  • You or your child will be attached to a heart-lung machine that acts as the heart and lungs.

  • The surgeon will remove the abnormal aortic valve.

  • The surgeon will also remove the pulmonary valve and attach it to where the aortic valve used to be—between the right ventricle and the pulmonary artery.

  • Once all the repairs have been done and you or your child's heart is beating sufficiently, doctors will remove the heart-lung machine.

  • The breastbone will be put back together with wires.

  • The surgeon will close the muscle and the skin. A dressing will be applied.

After the procedure:

  • Vital signs will be closely watched.

  • You or your child may be groggy and disoriented at first.

  • You or your child will feel some soreness, but not severe pain.

  • You or your child may be able to drink as soon as the day after surgery.

  • You or your child will likely need to stay in the hospital for two to three weeks.

How do I care for myself or my child after the Ross procedure?

After you leave the hospital:

  • Be sure to keep all follow-up appointments.

  • You or your child should be able to go back to normal activities relatively soon. But may be more tired than usual for a while after the surgery.

  • Ask about any exercise limitations. Children should avoid strenuous activities and physical activities that might involve blows to the chest.

  • Call the healthcare provider if you notice fever, increased draining from the wound, or any severe symptoms.

  • Follow all the healthcare provider's instructions for medicine, exercise, diet, and wound care.


Most of the time, symptoms improve soon after surgery. You or your child will need lifelong follow-up care with a cardiologist to watch for possible complications from the procedure. You or your child may also need to take antibiotics before certain medical or dental procedures to prevent an infection of the heart valves.