Aortic valve repair for isolated right coronary leaflet prolapse

Use of aortic wall patches as leaflet replacement material during aortic valve repair

“…Deficient commissures could be bridged for ruptured fenestrations or detached commissures, a problem that has vexed AVr for a while. 17 In patient 7, a centrally retracted leaflet could be addressed by insertion of an “artificial nodulus Arantius” to allow central leaflet coaptation. In this case with 2 leaflets retracted, augmenting only one with a larger patch provided enough tissue for full valve competence.…”

“…This patient was a 62-year-old male who presented with heart failure and was found to have a dilated annulus and severe posterior AI jet ( Video 5 ), consistent with right coronary leaflet prolapse. 17 Annular diameter was 25 mm, and coronary angiography showed 2-vessel coronary disease. On closer inspection of the echo, the right leaflet was flail, and the jet actually originated more from the right-left commissure, suggesting a commissural defect.…”

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

“…Frequently, the 3 sinuses are of relatively equal size, and the patients often are referred as trileaflet aortic insufficiency. Many have a posteriorly directed eccentric jet, similar to isolated right coronary leaflet prolapse, 14 but in others, the jet is more central. In contrast to isolated right coronary leaflet prolapse, patients with IBAV usually are younger and do not have a leaflet fracture line and broken right leaflet tip.…”