The Ross procedure for recurrently failed aortic valve procedures.

The Ross procedure provides young patients with unrepairable aortic valve disease with a living pulmonary autograft that confers significant survival benefit and improved quality of life. However, the procedure is complicated, and surgeons can be reluctant to offer it as a solution, especially in complex re-operative scenarios. We present a young patient with symptomatic, severe aortic insufficiency who had undergone two failed aortic valve procedures for congenital bicuspid aortic valve disease within the prior year. They presented with recurrent congestive heart failure, patient prosthesis mismatch and a severe paravalvular leak. We performed a Ross procedure to restore aortic valve function and quality of life. Despite the increased re-operative complexity, these young patients have the most to benefit from pulmonary autograft reconstruction.