Reversed Graft Interposition in the Ross Procedure

We report a Ross procedure employing a reversed graft interposition technique to assist proximal autograft implantation. A prosthetic vascular graft was preanastomosed to the sinutubular junction of the pulmonary autograft and folded inward, expanding the valve ring to enable uniform and precise suture placement. The same graft was used for distal reconstruction to stabilize the sinutubular junction. The patient had an uneventful recovery with only trivial autograft regurgitation. This simple technique may improve valve ring visualization and facilitate autograft handling during the Ross procedure.