Insights from 36 years' follow up of a patient with the Ross operation.

: Pulmonary autograft replacement of the aortic valve has been shown to have many potential advantages over other forms of aortic valve replacement. However, there is still a paucity of studies that provide new information about the possible behavior of the two valves and the cardiac and extracardiac responses in the very long-term. Here, a patient is presented who underwent this operation 36 years ago, together with detailed anatomical and physiological documentation. This case report serves to illustrate several important features relating to the late behavior of the two valves, the response of the two ventricles, and the 'quality of life' of the patient.