Saccular aneurysm of pulmonary autograft after the Ross procedure

The Ross procedure, which includes removal of the malformed aortic valve an d replacement of a pulmonary autograft in the aortic position, has increase d the number of available treatment options. Recently, dilatation of the au tograft pulmonary root after the Ross procedure has been reported as a comp lication. We report a patient with bicuspid aortic valve malformations and aortic annulus dilatation, who had a saccular-form, true-type, aneurysm in the pulmonary autograft seven months after the Ross procedure. These change s have not been described so far as complication. Pathologically, marked mu coid degeneration was noted in the tunica media of the aneurysm, as well as in the original aortic root. These findings may suggest similar pathologic al characteristics between the aorta and pulmonary arteries. Hence, the sur gical risks accompanying vascular characteristics in patients with congenit al aortic valve malformations should be considered.