Ross Procedure to the Rescue-Salvaging a Young Patient After Failed Valve-Sparing Aortic Root Replacement.

backgroundInitial treatment failure in young patients with aortic valve disease requires effective strategies beyond prosthetic replacement. This case demonstrates the Ross procedure (RP) as salvage for a failed valve reconstruction. CASE SUMMARY: A 21-year-old man with a unicuspid aortic valve, severe regurgitation, and root aneurysm underwent valve-sparing root replacement with an acceptable intraoperative result. In the early postoperative period, he developed severe regurgitation and complete heart block requiring temporary pacing and subsequent reoperation. An RP was performed with a good result with somewhat surprisingly complete resolution of conduction abnormalities. At 6-month follow-up, the examination revealed normal sinus rhythm, trace autograft regurgitation, preserved ventricular function, and return to normal activities. DISCUSSION: This case demonstrates the RP's effectiveness as a salvage strategy, resulting in hemodynamic normalization and conduction recovery, preventing prosthetic valve and pacemaker dependency. TAKE-HOME MESSAGE: The RP should be considered as an initial treatment or a salvage option for young adults with failed aortic valve repair.