Aortic valve dysfunction after valve-sparing root replacement is rare, and the risk depends mainly on the quality of the valve at the time of surgery. If reoperation is needed, the surgical options are a valve replacement inside the graft or a Bentall procedure. Because of the young age of these patients, a Ross operation seems feasible, considering such advantages as durability and avoidance of lifelong anticoagulation treatment. Nevertheless, one must take into consideration autograft harvesting difficulties and root dissection risks. [...]
Tamer, S., de Kerchove, L., Manzano, N. C., & El Khoury, G. (2014). Ross operation after failed valve-sparing reimplantation: pulmonary autograft inclusion into the previously implanted Valsalva graft. The Journal of Thoracic and Cardiovascular Surgery, 147(1), 534-536. https://doi.org/10.1016/j.jtcvs.2013.08.083 (Original work published 2014)