Past Medical History: 
The patient underwent a Ross procedure in 2002 for congenital bicuspid aortic stenosis which was complicated by post-procedure cardiac arrest due to left main coronary obstruction. This was treated with emergent coronary bypass surgery utilizing left internal mammary artery (LIMA) to left anterior descending (LAD) and saphenous vein graft (SVG) to the left circumflex (LCx) coronary artery. The patient was subsequently found to have aortic valve paravalvular leak (PVL) with fistulization of the non-coronary cusp to the left ventricle and right coronary cusp to right ventricle requiring redo sternotomy for correction. In 2013, he developed severe pulmonary homograft stenosis as well as a pseudoaneurysm of the LVOT necessitating repeat sternotomy with pulmonary homograft replacement and concomitant bioprosthetic aortic valve replacement.  In 2014, the patient underwent another sternotomy for patch repair of recurrent LVOT/RVOT pseudoaneurysm which was complicated by aortic valve insufficiency requiring repeat aortic valve replacement with a 21mm Edwards Magna Ease valve. His post-op course was complicated by recurrent episodes of endocarditis and development of an annular abscess resulting in multiple hospital admissions in 2014, 2015 and 2017 for intravenous antibiotic treatment.