Ross operation after failed valve-sparing reimplantation: Pulmonary autograft inclusion into the previously implanted Valsalva graft  Saadallah Tamer,

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Ross operation after failed valve-sparing reimplantation: Pulmonary autograft inclusion into the previously implanted Valsalva graft  Saadallah Tamer, MD, Laurent de Kerchove, MD, Norman Colina Manzano, MD, Gebrine Elkhoury, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 147, Issue 1, Pages 534-536 (January 2014) DOI: 10.1016/j.jtcvs.2013.08.083 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Intraoperative photograph of autograft inclusion technique in patient 2. A, Minimal Valsalva graft dissection and transversal aortotomy 1 cm above the sinotubular junction of the graft. B, Proximal suture line at the level of the aortic annulus, which equally corresponds to the proximal end of the Valsalva graft. C, Commissural implantation in a symmetric disposition, aligned with the sintotubular junction of the graft. D, Final aspect of the implanted autograft, after the distal suture line placement. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 534-536DOI: (10.1016/j.jtcvs.2013.08.083) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions