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"Can Leaky Pulmonary Valves Work for the Ross Procedure?" asks Tim

Written By: Adam Pick, Patient Advocate, Author & Website Founder
Medical Expert: Christopher Burke, MD, Cardiac Surgeon, UW Medicine Heart Institute
Published: July 20, 2023

I'm receiving lots of excellent patient questions about the Ross Procedure.

For example... Tim, a patient from the United Kingdom, just asked me, "Hi Adam - Congrats on a great website! I have a question about the Ross Procedure. Do you know if it is possible to do the Ross Procedure if there is mild leaking of the pulmonary valve? I know mild leaking of the pulmonary valve is very common. Thanks!"

To provide Tim an expert response, I contacted Dr. Christopher Burke, a leading Ross Procedure surgeon from UW Medicine Heart Institute in Seattle, Washington.

Dr. Christopher Burke

Minutes after sending Dr. Burke the question from Tim, my inbox lit up with a response from Dr. Burke.

Leaking Pulmonary Valves & The Ross Procedure?

Dr. Burke wrote in his email:

Adam, That's a very good question from Tim. Many pulmonary valves have a small leak at baseline. This is normal and often referred to as "trace". However, occasionally we see pulmonary valves that have a little more leak than simply a physiologic leak. In this case, we will often examine the valve leaflets in the operating room prior to taking out the pulmonary autograft to ensure the leaflets are healthy enough for a Ross procedure. In short… It depends on how much the valve is leaking at baseline as well as the health and geometry of the leaflets.

Ross Procedure Diagram

Repairing Pulmonary Valves During The Ross Procedure?

After seeing this response, I had a follow-up question for Dr. Burke about whether or not the pulmonary valve is ever repaired prior to being placed in the aortic position during the Ross Procedure. So, I asked Dr. Burke, "Have you ever done a repair to a pulmonary valve prior to placement in the aortic position during a Ross Procedure? In his response, Dr. Burke stated:

In extremely limited situations. This is rare and not routinely performed.

Pulmonary Valve Suitability For The Ross Procedure?

Finally, I had one last question for Dr. Burke specific to the pulmonary valve. I asked Dr. Burke, "How often, during the Ross Procedure, do you evaluate the pulmonary valve and determine it is not suitable for placement in the aortic valve position?" Dr. Burke responded:

Good question… It's pretty rare. Perhaps 1-2% of the time. We usually have a very good idea going into the operation.

Many Thanks Tim and Dr. Burke!

On behalf of our patient community, many thanks to Tim for his question and Dr. Burke for sharing his clinical experiences specific to the Ross Procedure!

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

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