Hospital Ruber International provides the Ross Procedure using contemporary valve-replacement techniques and evidence-based cardiac care. Founded in 1982, the ISO accredited hospital is based in Madrid, Spain, with 345 beds and services for domestic and international patients.

During the procedure, the surgeon removes the diseased aortic valve and repositions the patient's pulmonary valve in the aortic position. A donor pulmonary valve is then used to replace the original pulmonary valve. The procedure is complex and requires careful assessment of valve anatomy, heart function, and the patient's overall health.