Ross procedure shows promise in aortic valve surgery in familial hypercholesterolemia

A recent poster presented at the 2025 American College of Cardiology’s Annual Scientific Session evaluated surgical outcomes in patients with homozygous familial hypercholesterolemia (HoFH) undergoing aortic valve replacement (AVR). Researchers analyzed data from 134 patients with confirmed HoFH, with 24 requiring surgery for severe aortic stenosis (AS).

Among these patients, 8 underwent the Ross procedure, while 16 received alternative AVR surgeries. The study found that those undergoing the Ross procedure had a longer mean time-to-event (mortality or reoperation) of 14 years compared to 6 years for other surgical approaches. In addition, 70.8% of patients required coronary artery bypass grafting during surgery.

Genetic testing confirmed LDLR mutations in 78% of cases, and half of the cohort was receiving regular plasmapheresis. The findings suggest that the Ross procedure may offer superior long-term outcomes for select patients with HoFH with AS.

Reference
Abdelkader AE, et al. Outcomes of the Ross procedure versus conventional surgery in homozygous familial hypercholesterolemia patients with aortic valve stenosis. Poster presented at: 2025 American College of Cardiology Annual Scientific Session; March 29-31, 2025; Chicago, IL.