The Ross operation in young adults is associated with an excellent survival in the long term that is comparable with the general population. Although there is a risk of reoperation, incidence of other valve-related events is very low. The use of pulmonary autograft should be considered in any young adult patient requiring aortic valve replacement.
Active MV endocarditis remains a life-threatening disease. In experienced centres, an early and repair-oriented surgical approach can achieve relatively high reparability rates with good long-term durability of the repair and a very low recurrence rate of endocarditis. Patients could benefit from MV repair even if patch material is necessary to repair the valve.
The use of aortic homograft in acute aortic valve endocarditis is associated with a remarkably low risk of relapsing infection and very acceptable long-term survival. The risk of reoperation due to SVD is significant after one decade especially in young patients. The aortic homograft seems to be ideally suited for reconstruction of the aortic valve and cardiac structures damaged by the infective process especially in early surgery.
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