Beckerman says one reason why the Ross operation is not used more is a number of persistent myths about the method and its outcomes. However, data show that these myths are misconceptions.

“Many believe that the Ross is riskier and recovery is longer, or it’s not durable, or it’s not for older patients,” says Beckerman. “Numerous long-term, large-scale patient series, as well as meta-analyses, show that the Ross is actually the only procedure that can restore long-term survival to match that of the general population.”

To many cardiologists, it may seem that the Ross operation converts a single-valve disease into two-valve disease. “In a sense, that’s true,” Beckerman says. “But functionally, that distinction is meaningless when the procedure shows better hemodynamics and long-term survival than mechanical or preserved tissue valve replacements.”

With Beckerman’s arrival at Duke, the Ross operation has once again been offered to patients as part of the adult congenital heart disease program — but the Ross technique has long been offered for pediatric patients at Duke. This has led to further innovation, including using a living root in the pulmonic position, as in the infant domino partial heart transplant. “When we use a fresh, non-cryopreserved valve, we see better results,” says Beckerman. “It has the potential to further improve the Ross. Using living roots from explanted hearts shows truly good organ stewardship.”

The procedure remains an excellent option for aortic valve surgery, says Beckerman. “Any aortic valve disease is amenable to the Ross operation, whether that’s valve stenosis or insufficiency and whether there is associated aortic aneurysm or not. If your patient’s life expectancy is at least twenty years, they would benefit from a Ross performed by an experienced surgeon.”

The Ross procedure is another way that Duke offers specialized care for adult congenital heart disease whether patients are newly diagnosed or treatment is ongoing. One of only two programs in North Carolina accredited by the Adult Congenital Heart Association, Duke offers innovative treatments and therapies as one of the best hospitals in the nation for cardiology and heart surgery.