Redo Root Replacement using the Ross in Valsalva Technique

The Ross procedure is an alternative option for young and middle-aged patients needing aortic valve replacement. We present an interesting case where the patient had a preexisting aortic homograft that was implanted because of previous infective endocarditis with aortic root abscess. The patient presented with biological degeneration of the homograft with resultant severe stenosis as well as insufficiency. We performed a redo root surgery to replace the homograft with the Ross procedure by using the autograft inclusion into a vascular graft technique. The dissection was carried out by performing external dissection of the aortic root. Redo root replacement is a difficult procedure, however external root dissection is a safe and easy technique that can be used in such a difficult scenario.