Modified ross procedure to prevent autograft dilatation

The most prominent, long-term complication after the Ross procedure is autograft dilatation that can present within 1 to 2 years after the Ross operation. We describe a modified Ross procedure in which the autograft is completely encased in a Dacron graft (Hemashield; Maquet Cardiovascular, Wayne, NJ) prior to implantation. We have performed 30 modified Ross procedures since October 2004. There has been no mortality, and at follow-up none of the patients showed autograft dilatation. This article describes our current technique, which we believe is consistently reproducible and may be especially applicable to adults who are at risk for autograft dilatation after the Ross procedure.