Starnes VA, Elsayed RS, Cohen RG, et al. - Outcomes with wrapped (pulmonary autograft inclusion) vs unwrapped techniques were compared in adults with bicuspid aortic valves undergoing the Ross procedure. Among 129 adults with bicuspid aortic valves (age ≥ 18 years) who underwent the Ross procedure by a single surgeon, 71 underwent the procedure without autograft inclusion (unwrapped) and 58 with autograft inclusion (wrapped). Outcomes suggest that the Ross procedure with pulmonary autograft inclusion stabilizes the aortic root preventing dilatation and decreases the need for reoperation in adults with bicuspid aortic valves. In this population, the autograft inclusion technique aids conduction of the Ross procedure with excellent long-term outcomes.