The Ross Procedure: Expanding Options in Aortic Valve Surgery for Young Adults
After fleeing war in Ukraine and facing a failing heart valve, Stanislav Istratiy found hope at UHealth, where cardiothoracic surgeon Dr. Ciro Amodio successfully performed UHealth Tower’s first complex redo Ross procedure.
When Stanislav Istratiy opened his eyes after heart surgery, he remembers seeing the surgeon he had trusted with his life and smiling with relief. He had made it.
His cardiothoracic surgeon, Ciro Amodio, M.D., co-director of the Comprehensive Aortic Center and associate professor in the Division of Cardiothoracic Surgery at the University of Miami Miller School of Medicine, also remembers the moment well.
“He looked at me, full of joy, with a huge smile on his face,” Dr. Amodio recalled. “He had done so well.”
Outside the room, Stanislav’s wife was waiting. She had carried much of the family’s fear throughout the process, worrying about the operation and what might happen to her husband. Dr. Amodio brought her to see Stanislav as soon as possible and told her that everything had gone well.
For Dr. Amodio, moments like these make the long hours and technical demands on complex cardiac surgery worthwhile.
“The best moment is talking to their families. They can’t hold themselves together. They start hugging me and expressing their gratitude. These operations provide hope for the future, not just for the patient but for the entire family,” he said.
A Heart Condition Discovered Too Late
Stanislav’s heart-valve journey had begun nearly a decade earlier. While living in Ukraine, Stanislav was 28 when what seemed like a typical cold progressed into pneumonia. Soon afterward, he developed severe heart-rhythm problems. Testing revealed that he had been born with a bicuspid aortic valve, a condition where the aortic valve has two leaflets instead of the usual three.
His valve had deteriorated to a critical point, and he needed urgent surgery.
Stanislav first sought treatment in Kyiv, where doctors explained that he could receive either a mechanical valve or a biological valve. A mechanical valve could be durable but would likely require lifelong anticoagulation medicine and regular monitoring. A biological valve would allow him to avoid that burden, but it wouldn’t last forever.
At 28, neither option felt ideal. Because his father lived in Italy, Stanislav traveled there for another opinion. In early 2017, he underwent aortic valve replacement surgery and received a biological valve. He understood that the valve would eventually deteriorate, but the choice allowed him to live without daily anticoagulation.
Escaping War, Finding UHealth
In the years that followed, Stanislav’s life changed dramatically.
After the war in Ukraine began, he and his family relocated to the United States. He worked as a long-haul truck driver, spending extended periods on the road to support his wife and their two young children. With his family depending on him, maintaining his health and his ability to work became increasingly important.
By the end of 2025, Stanislav could no longer ignore signs that something was wrong. While flying home after work, he nearly lost consciousness. His cardiologist discovered that his biological valve had calcified and was failing.
Stanislav once again faced the prospect of major heart surgery. He didn’t want another biological valve that might eventually fail. With a career that required frequent travel, he also hoped to avoid a mechanical valve that required lifelong anticoagulation.
“My wife and I immediately began searching for the right cardiac surgeon,” Stanislav said.
The Right Surgeon at the Perfect Time
His wife found Dr. Amodio, and they took comfort in his extensive experience in Italy, the same country where Stanislav had undergone his first surgery.
“My wife believed he would understand my medical history and be the best specialist for my case,” Stanislav said.
From their first consultation, Dr. Amodio carefully reviewed Stanislav’s records, answered his questions and explained the treatment options. He believed Stanislav could benefit from a Ross procedure.
What Is a Ross Procedure?
A Ross procedure is a specialized heart valve operation used to treat certain patients with aortic valve disease. During the procedure, the surgeon removes the patient’s diseased aortic valve and replaces it with the patient’s own healthy pulmonary valve. A donor valve is then implanted in the pulmonary position.
For carefully selected patients, the Ross procedure can provide a durable, long-term solution while avoiding the need for lifelong anticoagulation medication that is often required with mechanical heart valves.
The Ross procedure is one of the most technically challenging operations in cardiac surgery. Dr. Amodio had learned to perform it through extensive training in Europe and at the Clevland Clinic, but it had not been performed previously at UHealth Tower. Stanislav’s case was even more complex because it was a redo operation. Before completing the Ross procedure, Dr. Amodio first had to remove the previously implanted biological valve.
“What impressed me most was not only Dr. Amodio’s knowledge, but also his confidence, compassion and extraordinary experience,” Stanislav said. “When my insurance company delayed approval for the surgery, Dr. Amodio and his team worked tirelessly to resolve every issue. Thanks to their dedication, my surgery was scheduled within about a week.”
A Landmark First for UHealth
The operation was a complete success. Stanislav credits Dr. Amodio’s expertise and the care he received from the entire UHealth team.
“Throughout my hospitalization and recovery, I received exceptional care from every member of the medical team,” Stanislav said. “Their professionalism, kindness and constant support made an enormous difference during one of the most challenging moments of my life.”
For Stanislav, the operation provided far more than a functioning heart valve. It restored his ability to imagine the years ahead.
“Today, I feel healthy, strong and grateful,” he said. “I have returned to an active life. I can work, spend time with my wife and children, exercise and look toward the future with confidence. Most importantly, I can enjoy everyday moments with my family without constantly worrying about my heart.”
A Second Chance at Life
Stanislav has crossed countries, endured war and rebuilt his family’s life in a new home. Now, with his new chance at health, he can continue moving forward.
“I truly believe that Dr. Amodio’s expertise, years of experience and exceptional surgical skill gave me a second chance at life,” Stanislav said. “His confidence in recommending the Ross procedure and his ability to perform such a complex operation changed my future forever.”
Dr. Amodio and his team, he added, did more than perform a successful surgery.
“They restored my health, gave me hope and gave me the opportunity to live a full and meaningful life again,” Stanislav said. “I hope my story encourages others facing heart valve disease to never lose hope, to seek the best possible care, and to remember that the right surgeon can truly change a person’s life.”
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Tags: aortic valve replacement, arrhythmia, cardiothoracic surgery, Division of Cardiothoracic Surgery, Dr. Ciro Amodio, heart care, heart disease, Newsroom, Ross procedure