Coronary artery bypass grafting following Ross procedure in a patient with familial hypercholesterolemia

Patients with familial hypercholesterolemia and concurrent aortic valve disease are at exceptionally high risk of requiring repeat interventions due to coronary disease, in addition to management of valvular pathology. For effective management, it is important for these patients to have a multidisciplinary approach to their care with surgical and interventional cardiology input. In this report, we present a case of a 33-year-old female patient with a history of familial hypercholesterolemia and congenital aortic stenosis status post-Ross procedure who presents with unstable angina. We discuss the challenges and factors to consider in the management of this unique patient population.