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We have read the interesting article from Luciani and colleagues1 documenting the outcomes into the second decade after the Ross procedure in infants and children from the Italian Paediatric Ross Registry. The conclusion concisely stated that the Ross procedure was a low-risk palliative procedure for aortic valve abnormalities at the expense of valve-related reoperation.
Contrary to prior evidence, autograft reoperation was more common than homograft in their cohort, raising the concern about the autograft failure in paediatric population. …