Under-use of the Ross operation - A lost opportunity

摘要

The incidence and prevalence of valve disease is increasing worldwide. This increase is because of a failure to address the problem of rheumatic heart disease in developing countries and the increasing age of the world population.1 Between 2014 and 2050 the world population will increase from about 7-2 to 9-6 billion inhabitants, and the proportion of people aged over 60 years will increase from 12% to 21%.2 Concernitantly, the annual number of patients needing heart valve replacement is anticipated to almost triple.3 Notably, the .largest increase in the world population will be in developing countries and therefore, due to scarce resources, not all patients who need heart valve replacement will even have access to this treatment. Strategies to address these global problems are urgently needed. Replacement of the aortic valve is the commonest form of valve replacement, with up to 85 000 procedures done annually in the USA.