Late XXXX and @entity338 after Ross operation.

@entity1 @entity384 @entity338 @entity2070 @entity337 @entity2333 @entity3555
The Ross operation, a procedure of replacement of the diseased aortic valve with an autologous pulmonary valve, has many advantages such as no need for anticoagulation therapy and similar valve function and growth potential as native valves. However secondary @entity2333 has emerged as a significant complication and indication for reoperation. We report a 48-year-old @entity1 who had Ross operation in 1997 for a damaged bicuspid aortic valve and severe @entity337 due to subacute @entity3555 complicated by aortic root abscess. In 2009, 12 years later, progressive severe @entity337 with incomplete coaptation and mild dilatation of the aortic root was shown on echocardiography and contrasted CT, while the pulmonary homograft retained normal function. She subsequently underwent aortic valve replacement. Histopathological examination of the explanted neo-aortic valve and neo-arterial wall revealed @entity2070 formation at the nodulus Arantii area of the three valve cusps, ventricularis, and arterialis. The amount of elastic fibres in the neo-aorta media was less than usual for an aorta of this @entity1 's age but was similar to a pulmonary artery. The pathological findings were not different from other studies of specimens removed between 7 to 12 years after Ross operation. However, the pathophysiology and long-term implications of these findings remain debatable. Considering the anatomical and physiological changes induced by the procedure, separate mechanisms for @entity384 and @entity338 are worthy of consideration.
