Doctor Stories
Legacy of Excellence in Complex Heart Surgery Continues with Ross Procedure
08.16.2022
Joseph Woo, MD, is a nationally recognized cardiothoracic surgeon and leading researcher in new approaches to cardiovascular care. He is the chair of the Department of Cardiothoracic Surgery at Stanford Medicine.
For rare and complex heart procedures, Stanford Health Care is one of the few places patients and physicians can turn. This was true for California Air National Guardsman, Nathan Foss, whose bicuspid aortic valve had progressed to severe aortic stenosis.
Foss' Santa Barbra heart surgeon recommended a Ross procedure—an advanced, technically demanding surgery that is not widely available. Foss was referred to Stanford Health Care—one of the few academic medical centers that offer this procedure.
CARE AT STANFORD
Pioneering advanced treatment for conditions like congestive heart failure, aortic disease, arrhythmia, cardiomyopathy, and valvular heart disease.
Visit Heart Surgery Clinic »“The Ross procedure is a very rare type of open-heart surgery that few surgeons can do. We often receive referrals such as these,” said Joseph Woo, MD, professor and chair of cardiothoracic surgery at Stanford Medicine and the Norman E. Shumway Professor. It is one of the reasons Stanford Health Care is among the top 10 cardiology and heart surgery programs in the United States, Woo said.
Groundbreaking Developments in Heart Surgery
Stanford Health Care has a long history of innovation and excellence in heart surgery. In 1968, Norman Shumway, MD, performed the first successful adult heart transplant in the United States. That was followed by the world’s first successful heart-lung transplant in 1981.
Stanford Medicine heart surgeons are leaders in other types of intricate heart surgeries. “The Ross procedure also has a historical connection with Stanford Health Care,” Woo said. “It was actually developed here by Norman Shumway, but he never performed it on humans.”
Better Outcomes in Aortic Valve Replacement
In 1967, British surgeon, Donald Ross, MD, performed the first human surgery that would bear his name.
“During the Ross procedure, we take out the pulmonary valve and transfer it into the aortic valve position,” Woo said. The surgeon replaces the patient’s pulmonary valve with one taken from a cadaver.
The pulmonary valve is living tissue, and when it is transferred into the aortic valve, it grows into the heart and heals and this it can last a lifetime. The replaced pulmonic cadaver valve, when it eventually wears out, is simpler to access because of its location on the venous side of the body and can therefore be easily replaced.
Studies have found excellent long-term outcomes following the Ross procedure. One longitudinal study of 310 patients who underwent a Ross procedure over a 25-year period reported overall survival of 94.1% and 83.6% at 10 and 20 years, respectively.1 Another study of 212 patients found less than 1 in 5 (16.8%) required reoperation for either valve after 20 years.2
A Life Restored
Woo and his team performed the Ross procedure on Foss on April 7, 2021. The 3½-hour surgery was a success.
In October, the Air National Guard approved him for regular duty. This would not have been possible had Foss opted for a mechanical valve. The increased risk of blood clots and bleeding and required use of blood-thinning medication would have resulted in a military discharge.
At some point in Foss’ future, he will have to have another intervention. Foss is counting on Stanford Health Care to find new advances to help him when the time comes.
Heart Surgery at Stanford Health Care
Through research and innovation, Stanford Medicine physicians are finding new ways to treat complex heart conditions. They use the latest technologies and techniques to offer patients better, safer options.
For more information about the Heart Surgery Clinic at Stanford Health Care, visit our website. To refer a patient, call 650-724-7500 or email referral@stanfordhealthcare.org.
If you have questions about referring your patients, please contact Jesus (Jesse) Perez, market outreach executive liaison, at 650-353-8063 or jesusperez@stanfordhealthcare.org.
References
1Martin E, Mohammadi S, Jacques F, et al. Clinical Outcomes Following the Ross Procedure in Adults: A 25-Year Longitudinal Study. J Am Coll Cardiol. 2017;70(15):1890-1899.
2David TE, Ouzounian M, David CM, Lafreniere-Roula M, Manlhiot C. Late results of the Ross procedure. J Thorac Cardiovasc Surg. 2019;157(1):201-208.
About Stanford Health Care
Stanford Health Care seeks to heal humanity through science and compassion, one patient at a time, through its commitment to care, educate and discover. Stanford Health Care delivers clinical innovation across its inpatient services, specialty health centers, physician offices, virtual care offerings and health plan programs.
Stanford Health Care is part of Stanford Medicine, a leading academic health system that includes the Stanford University School of Medicine, Stanford Health Care, and Stanford Children’s Health, with Lucile Packard Children's Hospital. Stanford Medicine is renowned for breakthroughs in treating cancer, heart disease, brain disorders and surgical and medical conditions. For more info, visit: www.stanfordhealthcare.org.