A simple technique of commissural reconstruction in aortic valve–sparing surgery

Abstract

The minimally invasive surgical approach is an effective option even in elderly patients with intractable secondary pneumothorax. References1. Dillman RO, Zusman DR, McClure SE. Surgical resection and long-term survival for octogenarians who undergo surgery for non-small-cell lung cancer.

Evolution of techniques for repair of intermediate-type bicuspid aortic valves

“…At the time, this defect was poorly understood, and after repair as trileaflet valves, the patients were left with chronic Grade 2 residual aortic insufficiency. Subsequently, the pericardial augmentation technique was described 15 and implemented in our practice. However, recurrent aortic insufficiency was common due to degeneration of the pericardial augmentation patches ( Video 1 ) (Patient 1).…”

“…In publications by Vohra and colleagues, 15 IBAV was reconstructed by tricuspidization, which accommodated the presence of 3 relatively equal sinuses. Because the partially fused commissure was low, pericardial commissural augmentation was performed to raise the commissure and ensure good coaptation.…”

Original repair after Ross failure: A case report of bicuspidized unicuspid autograft

“…The patch was implanted using the butterfly technique to reconstruct a functional posterior commissure at 180 of the opposite one and creating 2 symmetric cusps with good mobility (Figure 2). 1 The previous pulmonary homograft was replaced with a new homograft because of concerns of beginning degeneration. The duration of cardiopulmonary bypass was 110 minutes Repair of failed pulmonary autograft valve after Ross procedure might extend the benefits of the intervention and preserve young patients' quality of life.…”

Aortic Valve Repair of a Stenotic Unicuspid Aortic Valve in Young Patients

“…Ozaki and colleagues [23] described an independent replacement of three cusps by three autologous pericardial cusps (tricuspidization method) and with this technique saw good short-and midterm results along with good valve hemodynamics and a good quality of life without the need for anticoagulation [1,23,30]. Vohra and colleagues [34] described the use of a single-patch commissural reconstruction for BAV type 1 with incomplete fusion of the conjoined cusp. For asymmetric valve with a large conjoined cusp and smaller nonconjoined cusp tricuspidazation is favorable.…”

“…For asymmetric valve with a large conjoined cusp and smaller nonconjoined cusp tricuspidazation is favorable. This technique was also preferred for UAV with a single normal commissure and 0, 1, or 2 rudimentary raphes, when a neocommissure is created at the raphe localization directly opposite the normal commissure [34]. According to the physiological situation, it is obvious that tricuspidization shows better hemodynamic variables compared with bicuspidization.…”