The problem with a Ross Procedure is cutting out a perfectly well valve from the pulmonary position to use in the aortic position. This leaves you open to two valve surgeries in the near future.
1. I have had the Ross Procedure done, but when I was 8, and at the time it was a viable choice to help me to grow. 14 years later, the valve began to regurgitate severely, my aorta was dilated and I began to get mild regurgitation in my pulmonary valve. Multiple surgeries are riskier, given the amount of scar tissue covering the heart from previous surgeries and complications do compound, I myself took a slight hit to my liver (I'm greatful that it regenerates). They also had difficulty in stabilising me as I was losing more blood than average, as I suspect it to be down to all that cutting of the previous scar tissue. Multiple surgeries are also bloody painful! - I blame the scar tissue and previous opening of the sternum.
As I've had a Ross procedure in the past, my pulmonary valve will need to be monitored and maybe replaced, less-invasively or even clipped to prevent regurgitation - (My hospital have said they have that tech right now).
'and the valve for a few people lasts 30 years' - Do you want to take that risk? for some people, especially on this forum, a Ross Procedure has not lasted very long at all; a few years at most.
2. Aortic homograft - I don't really know much about homografts in the aortic position, but sort of going back to 1, why do you want to guarantee yourself another surgery with compounded risks? Given your age, you could look at 3 maybe 4 replacements. Why subject yourself to that?
3. Mechanical valve. It has the chance to last your entire lifetime, I say chance because there are risks with all valve types really, mainly endocarditis, a chance of an aneurysm etc. These are very low, and the guaranteed chance of replacement with the other valves far outweigh these tiny risks. I'm not saying there's a guarantee that you won't need a mechanical valve replaced in the near future, but you have a high chance that you wont when compared with a ross procedure (2 valves) or the homograft which will probably not last that long. Many members on this forum have made it past the 25 year mark, dick has had his for 50 years.. wow.
The On-X valve also claims to retard pannus tissue with its pannus guards, which is a pretty neat feature.
I've only seen three real reasons to avoid a mechanical. One if you're female and want a child, two if you're old and a tissue valve could last the rest of your life and three if your body can't tolerate 'blood thinners' for some other reason.
'blood thinners' or anticoagulants is not an issue. I am self testing now and I am always in range. If it does go down (very rarely through) I can bump up the dose to take me within range. It takes me about 10 seconds a day to take the pills and a few minutes to draw my blood at home to check my INR - (I test weekly for peace of mind). I haven't had to change my diet at all.
Feel free to ask a lot of questions with regards to taking warfarin/coumadin. There are a lot of experienced members on this forum who can tell you more about the drug. From my experience however, it's not an issue at all!
I appreciate the decision at the end of the day is yours, I just hope you're aware of all the risks before settling on something.