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Editorial
. 2021 Jan 28:7:109-116.
doi: 10.1016/j.xjtc.2021.01.029. eCollection 2021 Jun.

Cusp repair techniques in bicuspid and tricuspid aortic valves

Yuanjia Zhu  1   2 , Y Joseph Woo  1   2
Affiliations
Editorial

Cusp repair techniques in bicuspid and tricuspid aortic valves

Yuanjia Zhu et al. JTCVS Tech. .
No abstract available

Keywords: aortic valve; aortic valve repair; bicuspid aortic valve; cusp repair.

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Figures

None
Common aortic repair techniques for bicuspid and tricuspid aortic valves.
Figure 1
Figure 1
A flowchart outlining the key indication criteria and technical steps for each repair technique.
Figure 2
Figure 2
A, The central free margin plication technique is used to recreate an adequate leaflet coaptation area by plicating the prolapsed cusp toward the annulus. B, A paracentral plication technique can also be performed by plicating the cusp closer to the commissure. C, Commissuroplasty can be performed asymmetrically by pulling the plication toward one of the commissures to realign the free margin of the prolapsed cusp.
Figure 3
Figure 3
The free margin resuspension technique can reestablish valvular competency by weaving a suture along the cusp-free margin.
Figure 4
Figure 4
Leaflet decalcification and resection followed by pericardial patch reconstruction repair for a bicuspid aortic valve. Specifically, an oval-shaped pericardial patch of an appropriate size is sutured in with a running suture to repair the resected aortic leaflet or raphe.
Figure 5
Figure 5
A, The aortic root is dissected to the root insertion plane into the ventricular muscle. The pathologic aortic root is resected with the coronary buttons harvested and retracted. B, Symmetric suspension of the commissures may reveal a prolapsed cusp. C, The commissures can be subsequently rotated, with simultaneous height adjustment to correct cusp prolapse. D, Type I bicuspid aortic valve can be successfully repaired using the valve-sparing root replacement technique by creating a 170°/190° commissural orientation.
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References

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