Reinforcement of the pulmonary autograft root in the Ross operation.

In this video tutorial we demonstrate our technique of root reinforcement of the pulmonary autograft in a Ross operation. This technique is being used with increasing frequently to prevent the formation of an aneurysm of the pulmonary autograft.  The patient presented in the video has a bicuspid aortic valve with severe symptomatic aortic valve stenosis and moderate regurgitation. After harvesting, the pulmonary autograft it is sized and a 3- or 5-mm oversized Valsalva vascular prosthesis is chosen for reinforcement and to prevent formation of an aneurysm. Sizing depends on the amount and thickness of muscle in the pulmonary autograft.