Ross Procedure Young Patient — RACP Adult Medicine MCQ

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HardCardiologyRoss Procedure Young PatientRACP Adult Medicine

A 35-year-old man requires aortic valve replacement for severe bicuspid aortic valve stenosis. He is otherwise healthy and active. He does not want lifelong anticoagulation. He plans to have children. What is the most appropriate valve prosthesis?

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Correct answer: C — Ross procedure (pulmonary autograft)

A young active man who wants to avoid lifelong anticoagulation — the Ross procedure (pulmonary autograft in aortic position + pulmonary homograft) offers excellent haemodynamics, no anticoagulation requirement, and autograft growth potential. It is the preferred option for young active patients at experienced centres. Bioprosthetic valves degenerate faster in young patients (<15 years durability). Mechanical valves require lifelong warfarin. The Ross procedure has the best long-term outcomes in young patients but requires surgical expertise.

Reference: CSANZ – 2024 – VHD; ESC 2021 VHD