Journal of Pediatric Cardiology and Cardiac Surgery

An autograft aneurysm with possible autograft regurgitation is one of the well-known complications late after the Ross procedure, and various modifications to avoid autograft aneurysm and autograft regurgitation had been reported. We present a middle-aged gentleman with distal autograft aneurysm with ascending aortic aneurysm despite the aortic root fixation by Dacron felt at the time of the Ross procedure 20 years ago. The valve-sparing root replacement by David technique was planned, but converted to Yacoub technique during the operation due to severe calcification of the fixation material with difficulty of aortic root dissection. The Ross procedure concomitant with autograft root fixation technique was able to prevent the autograft annulus dilatation; however, unable to prevent autograft sinus of Valsalva aneurysm. Yacoub technique was an excellent option to proceed with valve-sparing root replacement operation for an aneurysmal autograft with concomitant root fixation.