Hi Andy, This thread is a little old and it looks like Barry had his ross about the same time you did. Glad to hear things are going so well.
The Ross procedure - best of both??
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Hi Andy, This thread is a little old and it looks like Barry had his ross about the same time you did. Glad to hear things are going so well.
Thanks for the update. Happy to hear things are going well !!
rcdixon76
New member
My upcoming Ross with Dr. Stelzer in NYC
My upcoming Ross with Dr. Stelzer in NYC
Hi Guys,
First post here -- been lurking / researching for a good while though. I just met with Dr. Stelzer in NYC on 2/15 and set my Ross surgery for 2/27. I will be his #509 Ross patient -- he has had fantastic results which warrants my Houston - NYC travel. Like all of you, I have done a tremendous amount of research and at 38, Coumadin does not sound appealing at all. If mechanical was my only choice, I'd make the best of Coumadin and be done with it. Luckily, I've found a wonderful surgeon and staff and am 110% comfortable with Ross after my exhaustive research. I thought I'd quickly share a couple things that helped me make my decision.
First, there is the classic and legitimate concern about involving the perfectly normal pulmonary valve with Ross. Why involve a perfectly normal pulmonary valve right? In short, a pulmonary autograft has been proven to handle the higher pressures on the aortic side and is YOUR living tissue which facilitates good blood flow (hemodynamics). A mechanical valve can never function like living tissue. The Pulmonary side is less stressful due to the lower system pressure and handles homografts well. The traditional Ross concerns have been minimized greatly with different support techniques on the aortic root and oversizing the pulmonary homograft to account for scar tissue / slight shrinking which can cause leaking. These more recent support techniques (felt + dacron) have shown very promising results which of course will be further proven with additional time. I recently spoke with a 22 year Ross patient done by Stelzer who is doing great. Trust me, I'm not kidding myself -- I could need another surgery with Ross. But have you looked at the reop rates of mechanical valves? It's not rainbows and unicorns as was my early impression. Before my Ross choice, my potential Houston surgeons immediately recommended the St. Jude mechanical valve as if there were no other choice. But again, my work and play don't lend itself well to Coumadin as I play competitive sports and my work requires global travel. I would hate to have something go wrong with my INR levels while in a foreign country... On the bright side for mechanical valves, future anti-coagulants look promising but early tests have some drawbacks at this point. I hope at some point in the future we can all hope for trans-cath methods which keep us buttoned up!
God bless all of you -- wish me luck!
Regards,
Chris Dixon
Houston, TX
My upcoming Ross with Dr. Stelzer in NYC
Hi Guys,
First post here -- been lurking / researching for a good while though. I just met with Dr. Stelzer in NYC on 2/15 and set my Ross surgery for 2/27. I will be his #509 Ross patient -- he has had fantastic results which warrants my Houston - NYC travel. Like all of you, I have done a tremendous amount of research and at 38, Coumadin does not sound appealing at all. If mechanical was my only choice, I'd make the best of Coumadin and be done with it. Luckily, I've found a wonderful surgeon and staff and am 110% comfortable with Ross after my exhaustive research. I thought I'd quickly share a couple things that helped me make my decision.
First, there is the classic and legitimate concern about involving the perfectly normal pulmonary valve with Ross. Why involve a perfectly normal pulmonary valve right? In short, a pulmonary autograft has been proven to handle the higher pressures on the aortic side and is YOUR living tissue which facilitates good blood flow (hemodynamics). A mechanical valve can never function like living tissue. The Pulmonary side is less stressful due to the lower system pressure and handles homografts well. The traditional Ross concerns have been minimized greatly with different support techniques on the aortic root and oversizing the pulmonary homograft to account for scar tissue / slight shrinking which can cause leaking. These more recent support techniques (felt + dacron) have shown very promising results which of course will be further proven with additional time. I recently spoke with a 22 year Ross patient done by Stelzer who is doing great. Trust me, I'm not kidding myself -- I could need another surgery with Ross. But have you looked at the reop rates of mechanical valves? It's not rainbows and unicorns as was my early impression. Before my Ross choice, my potential Houston surgeons immediately recommended the St. Jude mechanical valve as if there were no other choice. But again, my work and play don't lend itself well to Coumadin as I play competitive sports and my work requires global travel. I would hate to have something go wrong with my INR levels while in a foreign country... On the bright side for mechanical valves, future anti-coagulants look promising but early tests have some drawbacks at this point. I hope at some point in the future we can all hope for trans-cath methods which keep us buttoned up!
God bless all of you -- wish me luck!
Regards,
Chris Dixon
Houston, TX
hi chris! i'm thrilled to read that you are putting your life in dr. stelzer's hands. he is a brilliant surgeon and if you mention my husband, joey yasgur, he will actually remember him well. in fact, we've been in touch with him over the years. had hoped to see him last year around this time when joey went in for an ablation procedure done by dr. mehta at mt. sinai.
dr. stelzer is absolutely the best. i have heard from other cardiologists that he is the one to go to.... that, for me, says a lot.
joey was #304!!! 10 years ago.
i thank God every day for dr. stelzer, this surgery (ross, or any for that matter), and for being blessed as we have been.
wishing you the best of luck.
be well, sylvia
dr. stelzer is absolutely the best. i have heard from other cardiologists that he is the one to go to.... that, for me, says a lot.
joey was #304!!! 10 years ago.
i thank God every day for dr. stelzer, this surgery (ross, or any for that matter), and for being blessed as we have been.
wishing you the best of luck.
be well, sylvia
Leeroy996
Well-known member
Stelzer 443
Stelzer 443
Hi Chris,
Paul told me he was up to 508. I'm #443. I seldom come onto this page nowadays. I'm out there living like a regular person with no problems. My Echos are good both pulmonary and aortic and I put my heart through a lot more than most.
I attached some photos from the last three weeks. I won a bike race 3 weeks ago and I won all of my motorbike races 2 weeks ago and lead the Championship cup series. I crash now and then but that's of no concern to me not being on any meds. I've done a few iron-man's etc since surgery and was able to beat most of the professionals on the bike. The general comment from my competition is that I'm cheating and the Ross procedure was performance enhancing.
If you have any questions before your surgery I'd be happy to answer. I wrote a diary detailing my progress after surgery. Paul is a good guy, I still keep in touch with him.
Stelzer 443
Hi Chris,
Paul told me he was up to 508. I'm #443. I seldom come onto this page nowadays. I'm out there living like a regular person with no problems. My Echos are good both pulmonary and aortic and I put my heart through a lot more than most.
I attached some photos from the last three weeks. I won a bike race 3 weeks ago and I won all of my motorbike races 2 weeks ago and lead the Championship cup series. I crash now and then but that's of no concern to me not being on any meds. I've done a few iron-man's etc since surgery and was able to beat most of the professionals on the bike. The general comment from my competition is that I'm cheating and the Ross procedure was performance enhancing.
If you have any questions before your surgery I'd be happy to answer. I wrote a diary detailing my progress after surgery. Paul is a good guy, I still keep in touch with him.
Jessica Marie
Member
I was recommended the Ross Valve for my last surgery in 2010! I grew up with my mechanical valve and once I found out I was able to get this type of valve I felt blessed and didn't exactly know what to do with the opportunity. They were planning on going ahead with the Ross Valve but during my surgery they saw there was way too much tissue built up around my mitral valve and I was unable to receive it. I was a little bummed out because the outcome of the Ross Valve would have given me the opportunity to be "normal" for once. I would have been able to have a couple children hopefully and wouldn't have to worry about those darn blood thinners. But that's okay because I don't think I would be the same without my tickers!! So I am still feeling blessed! I hope your experience with the Ross Valve is terrific!
uksteve
New member
How have you been doing after the procedure, my young son is due to go in for a ross in the coming months, just want to know what to expect & I guess i's different in Kids? How long does the op take? Thanks Steve
fgarran
Member
Hello Folks,
I just had Ross Procedure (March 28th) with Dr. Paul Stelzer from Mount Sinai Hospital in New York.
I am 37, live in Brazil and made the whole way to NYC because of Dr. Stelzer's reputation.
I couldn't be more satisfied. The surgery was successful and he is such a great person, who really makes you feel comfortable.
Off course, time will show how successful it was. By now, I am walking 10 blocks twice a day with no blood-thinner and eager to play tennis again. Anyone who had a similar story and would like to share, please, feel free.
Thanks, Felipe.
I just had Ross Procedure (March 28th) with Dr. Paul Stelzer from Mount Sinai Hospital in New York.
I am 37, live in Brazil and made the whole way to NYC because of Dr. Stelzer's reputation.
I couldn't be more satisfied. The surgery was successful and he is such a great person, who really makes you feel comfortable.
Off course, time will show how successful it was. By now, I am walking 10 blocks twice a day with no blood-thinner and eager to play tennis again. Anyone who had a similar story and would like to share, please, feel free.
Thanks, Felipe.
fgarran
Member
Ross Procedure
Ross Procedure
Hi Steve,
I don't know if my answers ares still in time. Here they go:
The op lasted 5 hours and 40 minutes. Recovery has been very good, yet a bit painful, but as painful as expected.
Ross Procedure
Hi Steve,
I don't know if my answers ares still in time. Here they go:
The op lasted 5 hours and 40 minutes. Recovery has been very good, yet a bit painful, but as painful as expected.
Some thoughts...
When it's successful, the Ross Procedure is the best of all worlds. No wearouts, no meds. Hands down the best.
The quandary is that when the Ross is being used for someone with a bicuspid valve, it's extremely difficult to determine whether they are at risk of developing connective tissue disorders over time that will damage the valve's usefulness. Those tissue disorders are often hand-in-hand with the bicuspid valve, but they don't always manifest themselves during the person's lifetime. What can happen is that the tissue in the valve becomes mixomatous (connective tissue is replaced by fibers and other, less capable tissues) and the once-pulmonary-now-aortic valve begins to leak, and eventually needs to be replaced. One special caveat: if the pulmonary is bicuspid, don't go with the Ross. That seems to decrease your odds of long-term success. Ask to go to your backup valve if that happens (yes, you should have a backup plan [and valve choice] in place, in case things aren't working out in the OR). One of the reasons the Ross is not as popular as it was is because it was done too often without proper concern given to that issue.
Surrounding tissues can also become problematic, causing more leakage and perhaps involving the mitral valve. Then, if that's replaced, you have three surgical spots in your heart.
Does this happen to everyone with a Ross? Certainly not, but there's a certain amount of crystal ball work involved in determining if it will happen to you, personally. Dr. Stelzer is certainly as good as any human can be at making that determination and of course, doing the operation itself. He is one of a handful of very top-shelf Ross Procedure surgeons.
You might still get an expanding aorta, but if the valve is still good, it can be spared with a modified David procedure, which keeps the valve in place while dealing with the aorta.
If you get a replacement pulmonary valve from a human donor, you will have a "crisis" point with it (apparently a rejection reaction), but once it passes, the pulmonary usually continues to function well. Paradoxically, I've read that the worse that crisi is, the better the replacement pulmonary valve works later. I know that pulmonay valves have been replaced via catheter, so there are new possibilities for the pulmonary piece working out nearly 100% of the time, one way or another.
For that matter, having the formerly-pulmonary-now-aortic valve fail some time after a Ross procedure would not make it impossible to replace via catheter, should you be quite old by then, or your body not be able to deal with more conventional surgery.
Best wishes,
When it's successful, the Ross Procedure is the best of all worlds. No wearouts, no meds. Hands down the best.
The quandary is that when the Ross is being used for someone with a bicuspid valve, it's extremely difficult to determine whether they are at risk of developing connective tissue disorders over time that will damage the valve's usefulness. Those tissue disorders are often hand-in-hand with the bicuspid valve, but they don't always manifest themselves during the person's lifetime. What can happen is that the tissue in the valve becomes mixomatous (connective tissue is replaced by fibers and other, less capable tissues) and the once-pulmonary-now-aortic valve begins to leak, and eventually needs to be replaced. One special caveat: if the pulmonary is bicuspid, don't go with the Ross. That seems to decrease your odds of long-term success. Ask to go to your backup valve if that happens (yes, you should have a backup plan [and valve choice] in place, in case things aren't working out in the OR). One of the reasons the Ross is not as popular as it was is because it was done too often without proper concern given to that issue.
Surrounding tissues can also become problematic, causing more leakage and perhaps involving the mitral valve. Then, if that's replaced, you have three surgical spots in your heart.
Does this happen to everyone with a Ross? Certainly not, but there's a certain amount of crystal ball work involved in determining if it will happen to you, personally. Dr. Stelzer is certainly as good as any human can be at making that determination and of course, doing the operation itself. He is one of a handful of very top-shelf Ross Procedure surgeons.
You might still get an expanding aorta, but if the valve is still good, it can be spared with a modified David procedure, which keeps the valve in place while dealing with the aorta.
If you get a replacement pulmonary valve from a human donor, you will have a "crisis" point with it (apparently a rejection reaction), but once it passes, the pulmonary usually continues to function well. Paradoxically, I've read that the worse that crisi is, the better the replacement pulmonary valve works later. I know that pulmonay valves have been replaced via catheter, so there are new possibilities for the pulmonary piece working out nearly 100% of the time, one way or another.
For that matter, having the formerly-pulmonary-now-aortic valve fail some time after a Ross procedure would not make it impossible to replace via catheter, should you be quite old by then, or your body not be able to deal with more conventional surgery.
Best wishes,
Ross Procedure must be the best of both worlds IF it doesn't need replacement. Fully functioning heart with no need for anti-coagulant. The big issue is that IF!
From reading posts here, it would seem that there are plenty of people here who unfortunately did need a re-operation. As I've stated on another thread, it would seem to me that anyone who had the Ross and it didn't work out after 10/15 years are likely to be active on this site (as they need info on re-op/their new valve/anti-coagulant.) Patients who had the Ross 10/15/20+ years ago, and still have perfectly functioning valves, are, imo, not as likely to post here, as they would have no heart valve issues.
Im currently waiting on a date for my surgery. My surgeon told me that he has done around 100 Ross Procedures and only needed to re-do 1. Those are good odds. When I asked him why are other studies showing 10% re-dos after 10 yrs and 20% after 20 years, he replied that some surgeons try to MAKE the pulmonary valve fit, whereas he would only do the op if it fits exactly. I forgot to ask about the wrapping of the ascending aorta, which caused many re-do's in earlier Ross Procedure patients.
However he kept stating that the Ross should last 20yrs plus.
As I'm turning 30 next week, I explained to him that I'm hoping to live another 50 yrs and asked what happens after 20? His answer was that if the Ross lasts 20 yrs then you could be pretty sure it will last the rest of your life.
I want to get the Ross to avoid warfarin because I play Gaelic football, a reasonably physical contact sport. Furthermore I would worry that INR levels would be something that I would constantly worry about.
From reading posts here, it would seem that there are plenty of people here who unfortunately did need a re-operation. As I've stated on another thread, it would seem to me that anyone who had the Ross and it didn't work out after 10/15 years are likely to be active on this site (as they need info on re-op/their new valve/anti-coagulant.) Patients who had the Ross 10/15/20+ years ago, and still have perfectly functioning valves, are, imo, not as likely to post here, as they would have no heart valve issues.
Im currently waiting on a date for my surgery. My surgeon told me that he has done around 100 Ross Procedures and only needed to re-do 1. Those are good odds. When I asked him why are other studies showing 10% re-dos after 10 yrs and 20% after 20 years, he replied that some surgeons try to MAKE the pulmonary valve fit, whereas he would only do the op if it fits exactly. I forgot to ask about the wrapping of the ascending aorta, which caused many re-do's in earlier Ross Procedure patients.
However he kept stating that the Ross should last 20yrs plus.
As I'm turning 30 next week, I explained to him that I'm hoping to live another 50 yrs and asked what happens after 20? His answer was that if the Ross lasts 20 yrs then you could be pretty sure it will last the rest of your life.
I want to get the Ross to avoid warfarin because I play Gaelic football, a reasonably physical contact sport. Furthermore I would worry that INR levels would be something that I would constantly worry about.
river-wear
Well-known member
This idea of the "best of both worlds" is why I'm traveling 3000 miles to try for a repair. Only leaky, non-calcified aortic valves can be repaired at this point, but hopefully this procedure will become as well known and successful as mitral valve repair.
Pat - good luck with your Ross. It sounds like you've found an excellent surgeon.
Pat - good luck with your Ross. It sounds like you've found an excellent surgeon.
Marc
Member
Maybe you like this article a meta-analysis arround the ross procedure:
http://circ.ahajournals.org/content/119/2/222.full
http://circ.ahajournals.org/content/119/2/222.full
