Donald Nixon Ross,
FRCS
Fellowship of the Royal Colleges of Surgeons (FRCS) is a professional qualification to practise as a senior surgeon in Ireland or the United Kingdom. It is bestowed on an intercollegiate basis by the four Royal Colleges of Surgeons (the Royal C ...
(4 October 1922 – 7 July 2014) was a South African-born British
thoracic surgeon
Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart (heart disease), lungs (lung disease), and other pleural or mediastinal struc ...
who was a pioneer of
cardiac surgery
Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to corr ...
and led the team that carried out the first
heart transplantation
A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. , the most common procedu ...
in the
United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
in 1968. He developed the pulmonary autograft, known as the
Ross procedure
The Ross procedure, also known as pulmonary autograft, is a heart valve replacement operation to treat severe aortic valve disease, such as in children and young adults with a bicuspid aortic valve. It involves removing the diseased aortic valv ...
, for treatment of aortic valve disease.
Early life and education
Donald Ross was born in
Kimberley
Kimberly or Kimberley may refer to:
Places and historical events
Australia
* Kimberley (Western Australia)
** Roman Catholic Diocese of Kimberley
* Kimberley Warm Springs, Tasmania
* Kimberley, Tasmania a small town
* County of Kimberley, a ...
,
South Africa
South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. It is bounded to the south by of coastline that stretch along the South Atlantic and Indian Oceans; to the north by the neighbouring countri ...
, on 4 October 1922.
[Pioneers of Cardiology: Donald Ross, DSc, FRCS](_blank)
''Circulation'': European Perspectives, 6 March 2007, downloaded from http://circ.ahajournals.org/ by guest on 25 December 2012
/ref> His parents were Scottish
Scottish usually refers to something of, from, or related to Scotland, including:
*Scottish Gaelic, a Celtic Goidelic language of the Indo-European language family native to Scotland
*Scottish English
*Scottish national identity, the Scottish ide ...
. He matriculated from Kimberley Boys' High School
Kimberley Boys' High School is a state secondary school or high school situated adjacent to the Honoured Dead Memorial, in the arc between Dalham and Memorial Roads, Kimberley, Northern Cape, South Africa – a site it has occupied since January 19 ...
in 1939.
Early career
He began his medical career enrolling as a student at the University of Cape Town
The University of Cape Town (UCT) ( af, Universiteit van Kaapstad, xh, Yunibesithi ya yaseKapa) is a public research university in Cape Town, South Africa. Established in 1829 as the South African College, it was granted full university statu ...
, training first as a dedicated scientist and subsequently as a doctor
Doctor or The Doctor may refer to:
Personal titles
* Doctor (title), the holder of an accredited academic degree
* A medical practitioner, including:
** Physician
** Surgeon
** Dentist
** Veterinary physician
** Optometrist
*Other roles
** ...
. He graduated (BSc, MB, ChB) in 1946 with first-class honours and the university gold medal. He had also received a two-year overseas scholarship which allowed him to further his studies in the United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
.
Career in surgery in England
Ross has recalled eagerly accepting the scholarship: once in England he took up a career in surgery and became a Fellow of the Royal College of Surgeons
Fellowship of the Royal Colleges of Surgeons (FRCS) is a professional qualification to practise as a senior surgeon in Ireland or the United Kingdom. It is bestowed on an intercollegiate basis by the four Royal Colleges of Surgeons (the Royal C ...
(1949) within two years instead of the usual three. Working initially in Bristol
Bristol () is a city, ceremonial county and unitary authority in England. Situated on the River Avon, it is bordered by the ceremonial counties of Gloucestershire to the north and Somerset to the south. Bristol is the most populous city in ...
he focused on chest and oesophageal surgery, and then began to include early cardiac surgery, such as on the ductus arteriosus
The ''ductus arteriosus'', also called the ''ductus Botalli'', named after the Italian physiologist Leonardo Botallo, is a blood vessel in the developing fetus connecting the trunk of the pulmonary artery to the proximal descending aorta. It allo ...
. He was appointed Senior Registrar in Thoracic Surgery, Bristol, in 1952.
Ross acknowledges the particular influence on his career of two key figures: Ronald Belsey, MD, and Russell Claude Brock
Russell Claude Brock, Baron Brock (24 October 1903 – 3 September 1980) was a leading British chest and heart surgeon and one of the pioneers of modern open-heart surgery. His achievements were recognised by a Knighthood in 1954, a Life Peera ...
, FRCS, FRCP (later Lord Brock). Ross has recorded how Belsey, the oesophageal surgeon in Bristol with whom he was working, took him to Guy's Hospital
Guy's Hospital is an NHS hospital in the borough of Southwark in central London. It is part of Guy's and St Thomas' NHS Foundation Trust and one of the institutions that comprise the King's Health Partners, an academic health science centre.
...
in London
London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
to see Sir Russell Brock attempt to split open a calcified aortic valve. "There was no open-heart surgery in those days, and the operation was a dramatic failure. But the drama involved convinced me that I had to study new developments in cardiac surgery."
Ross had been a fellow student of Christiaan Barnard
Christiaan Neethling Barnard (8 November 1922 – 2 September 2001) was a South African cardiac surgeon who performed the world's first human-to-human heart transplant operation. On 3 December 1967, Barnard transplanted the heart of accident-v ...
at the University of Cape Town
The University of Cape Town (UCT) ( af, Universiteit van Kaapstad, xh, Yunibesithi ya yaseKapa) is a public research university in Cape Town, South Africa. Established in 1829 as the South African College, it was granted full university statu ...
, the man who carried out the world's first heart transplantation at Cape Town's Groote Schuur Hospital
Groote Schuur Hospital is a large, government-funded, teaching hospital situated on the slopes of Devil's Peak in the city of Cape Town, South Africa. It was founded in 1938 and is famous for being the institution where the first human-to-huma ...
. Throughout his early training, moreover, he had felt a lure toward chest surgery and cardiology because they seemed to be the most active specialities in an era when very little could be done for a patient with heart disease of any type.
Dr Brock, in charge of surgery at Guy's Hospital, took on Mr Ross as a cardiovascular Research Fellow (1953) and later as Senior Thoracic Registrar (1954). Four years later, in 1958, Ross was appointed Consultant Cardiothoracic Surgeon, and subsequently Consultant Surgeon, National Heart Hospital
University College Hospital at Westmoreland Street, named The Heart Hospital until refurbished and renamed in 2015, was a specialist cardiac hospital located in London, United Kingdom until 2015. It is part of the University College London Hospi ...
in London (1963), and Senior Surgeon there (1967). In 1970, he was made Director of the Department of Surgery at the Institute of Cardiology, London.
Ross retired in 1997.
First heart transplantation in the United Kingdom
It was in 1968 that Donald Ross led the team of doctors (including Keith Ross (no relation) and Donald Longmore
Professor Donald Longmore OBE, FRCSEd, FRCR (born 1928) is a British consultant surgeon and clinical physiologist. He was one of the team who performed the first heart transplant in the United Kingdom.
Longmore was a Consultant Surgeon and Cl ...
and the anaesthetist Alan Gilston
Dr Alan Gilston FRCS, FFARCS (1928-2005) was a British anaesthesiologist. He was one of the team who performed the first heart transplant in the United Kingdom.
Early life
His grandfather was Israel Gitlesohn, Bradford's first shohet, wh ...
.) and nurses at the National Heart Hospital in London in the United Kingdom's first heart transplantation
A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. , the most common procedu ...
. The operation, on a 45-year-old man, lasted 7 hours. The patient survived for another 46 days before dying from what was described at the time as an "overwhelming infection."
Looking back, Ross observed that it was almost logical that he should lead the team for the United Kingdom's first transplantation. "Operations on the open heart introduced the need to be able to deal with a quiescent heart action, so like most cardiac surgeons, I was involved in operating on an arrested heart and, as an extension of that, a quiescent transplanted heart…We felt that transplantation was a natural evolution."
There had been a surge of media attention around the heart transplantation, but the team had not considered the surgery itself particularly unique or challenging. The greatest issue faced was overcoming rejection of the newly transplanted heart. "We did not feel we had achieved any particular advances in transplantation at that time," Ross has said, "and we stopped after the third transplantation because the problem of rejection had not been overcome."
The Ross procedure
Ross's greater achievement was the development, in 1967, of what has been termed the Ross procedure
The Ross procedure, also known as pulmonary autograft, is a heart valve replacement operation to treat severe aortic valve disease, such as in children and young adults with a bicuspid aortic valve. It involves removing the diseased aortic valv ...
, or pulmonary autograft for aortic valve disease.
He has said that his interest had lain "particularly with the valves—especially the aortic valve—but, in general, anything that was related to the function of the heart." Initially he was involved in developing a bypass machine and the use of hypothermia to facilitate open heart surgery.
In 1962 Ross introduced the use of homografts to replace diseased aortic valves. He used a technique of subcoronary implantation developed in the laboratory by Carlos Duran and Alfred Gunning in Oxford.
Despite early promise, homografts had a limited life span of around 8 years. The pulmonary autograft, now widely known as the Ross procedure, first performed in 1967, was the logical development of the homograft: it involves replacing a patient's damaged aortic valve with his or her own pulmonary valve.
Ross believed that, "with care, the patient’s own living pulmonary valve could be transplanted to replace the diseased aortic valve in that critical and vulnerable position and that it could persist there permanently." The benefits of the procedure were that it did not require lifelong anticoagulation with its attendant risks, and it could grow proportionately with the patient, making it suitable for use in children.
Honours and awards
Ross is recipient of the following honours and awards:
* Honorary FRCSI, 1984
* Honorary FRCS Thailand, 1987.
* Honorary DSc CNAA, 1982.
* Clement Price Thomas
Sir Clement Price Thomas ''Honour for the King's Doctor''. ''The Times''. (London, England), 15 December 1951; p. 6; issue 52185. (22 November 1893 – 19 March 1973) was a pioneering Welsh thoracic surgeon most famous for his 1951 operation on ...
Award, Royal College of Surgeons, 1983.
* Order of Cedar of Lebanon, 1975;
* Order of Merit (1st class) (West Germany), 1981;
* Royal Order (Thailand), 1994.
Publications
* ''A Surgeon's Guide to Cardiac Diagnosis'', 1962;
* Co-authored ''Medical and Surgical Cardiology'', 1968;
* Co-authored ''Biological Tissue in Heart Valve Replacement'', 1972;
* He has also contributed to the ''British Medical Journal
''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'', ''The Lancet
''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823.
The journal publishes original research articles, ...
'' and other journals.
On future prospects in cardiac surgery
In retirement, Mr Ross anticipated much in the future of cardiac surgery, for example, with respect to the burgeoning role of radiology
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
in both the diagnosis and treatment of heart disease. He was an advocate for tissue engineering to address the worldwide shortage of human organs and tissues for transplantation procedures.
Extramural interests
Outside of his medical pursuits, Ross bred Arabian horse
The Arabian or Arab horse ( ar, الحصان العربي , DIN 31635, DMG ''ḥiṣān ʿarabī'') is a horse breed, breed of horse that originated on the Arabian Peninsula. With a distinctive head shape and high tail carriage, the Arabian is ...
s, and he had been a devotee of the theatre
Theatre or theater is a collaborative form of performing art that uses live performers, usually actors or actresses, to present the experience of a real or imagined event before a live audience in a specific place, often a stage. The perform ...
, opera
Opera is a form of theatre in which music is a fundamental component and dramatic roles are taken by singers. Such a "work" (the literal translation of the Italian word "opera") is typically a collaboration between a composer and a librett ...
, and, particularly, chamber music
Chamber music is a form of classical music that is composed for a small group of instruments—traditionally a group that could fit in a palace chamber or a large room. Most broadly, it includes any art music that is performed by a small numb ...
at the Wigmore Hall
Wigmore Hall is a concert hall located at 36 Wigmore Street, London. Originally called Bechstein Hall, it specialises in performances of chamber music, early music, vocal music and song recitals. It is widely regarded as one of the world's leadin ...
.
Death
He died in London on 7 July 2014.
References
External links
1968: Surgeons conduct UK's first heart transplant
*
{{DEFAULTSORT:Ross, Donald Nixon
1922 births
2014 deaths
University of Cape Town alumni
Fellows of the Royal College of Surgeons
Scottish surgeons
British cardiac surgeons
20th-century Scottish medical doctors
South African people of Scottish descent
People from Kimberley, Northern Cape
Fellows of the Royal College of Surgeons in Ireland
British transplant surgeons
20th-century surgeons
South African emigrants to the United Kingdom