Ross, but then you potentially have 2 valve disease. A Peds cardiac surgeon (they also does adults) would have working knowledge of this procedure. You can also do a double Ross depending on severity of the AI, and the neo-pulmonary valve can easily be addressed with percitaneous valves... until you run out of functional internal diameter.
The On-X mechanical valve has a lower INR recommendation in the mitral position and this has also been used in the aortic position, using an INR of 2-3 after the first 3-6months (not a to. Of data to support this in aortic position). While tissue valves are great, it’s is guaranteed to wear out, and not every institution is doing TAVR on you patients hat are still good surgical candidates.