Ventricular Septal Defect Jeopardizes the Autograft in a Ross Operation

The Ross operation is the gold standard for aortic valve replacement in young patients because it is a durable and anticoagulation-free alternative to mechanical aortic valve replacement. Careful assessment of the pulmonary valve is critical because it should become a durable neoaortic valve. Here we report the case of a patient in whom the pulmonary autograft was jeopardized by a large, doubly committed ventricular septal defect that did not offer sufficient autologous tissue for the proximal suture line. Surgeons should be aware that patients presenting with Laubry-Pezzi syndrome can be poor or challenging candidates for Ross procedures.