An Unusual Complication of the "Supported" Ross Procedure.

We present a unique surgical complication in a 19-year-old patient who underwent a "supported" Ross procedure for congenital aortic stenosis. In the present case, herniation of pulmonary autograft material through coronary fenestrations in the Dacron supporting material can be appreciated. This case suggests a possible need to modify surgical technique to ensure that all autograft tissue remains contained within the Dacron bolster.