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The pulmonary valve is very similar to the aortic valve, and it has been found that a patient's own pulmonary valve may successfully be substituted for a diseased aortic valve. The surgical procedure to accomplish this is called the Ross procedure. Essentially a pulmonary valve autograft is placed in the aortic valve position, and a homograft (human donor) valve replaces the pulmonary valve. This could be an ideal operation for a young or middle-aged patient who requires aortic valve replacement. It has particular significance for children, meeting their need for a new aortic valve that will grow with them. An additional benefit of the Ross procedure is resistance to infection. However, the extensiveness of the surgery may be beyond the tolerance of those patients who are already septic and experiencing multi-organ failure secondary to infection.

The Ross procedure is more complex and technically challenging than a single valve surgery. Up to 20 percent of patients will require re-operation for degeneration of the homograft within 10 to 15 years. This procedure is appropriate in selected young patients who do not have Marfan's syndrome or a connective tissue disorder.