Ross Procedure in an Infant

The Ross procedure, first described in 1967, involves replacement of a diseased aortic valve with a pulmonary autograft and placement of a pulmonary or aortic homograft between the right ventricle and pulmonary artery. After the Ross procedure, there is no need for anticoagulation, and the autograft has proved to be durable and to grow in proportion to somatic growth. Although aortic valve homografts have excellent postoperative hemodynamics, do not require anticoagulation and are associated with a low risk of thromboembolism, these homografts have limited durability and do not grow. Thus a pulmonary autograft is the most attractive alternative to mechanical, porcine and homograft valves in the treatment of aortic valve disease in children. We report a 4-month-old patient with congenital aortic stenosis who had an excellent outcome following treatment with the Ross procedure. To the best of our knowledge, this is the youngest patient to have undergone a successful Ross procedure in the Indian subcontinent.