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Bicuspid Aortic Valve Repair With Valve-sparing Root Replacement
John J. Kelly1, Christopher K. Mehta2, Brittany J. Cannon1, Nimesh D. Desai1, Joseph E. Bavaria1.
1University of Pennsylvania, PHILADELPHIA, PA, USA, 2Northwestern University, Chicago, IL, USA.

OBJECTIVE:
To demonstrate our step-by-step process in performing a bicuspid aortic valve repair with valve-sparing root replacement.
METHODS:
A 26-year-old male with a known congenital bicuspid aortic valve developed an aortic root aneurysm with severe aortic insufficiency. A valve-sparing root replacement using the reimplantation technique with bicuspid valve leaflet repair was performed. Filmed from an overhead perspective, this video captures each step of the procedure. This includes the careful dissection of the aortic root, the creation of the coronary buttons, the analysis of the bicuspid valve, bicuspid leaflet repair with plication of the conjoined cusp and figure-of-eight stitch at the left-non commissure, the placement of the sub-annular primary suture line, the sizing and implantation of the root graft, the reimplantation of the bicuspid valve commissures in a 180-180 arrangement, the secondary suture line securing the valve complex to the root graft, the reimplantation of the coronary buttons, and the final valve analysis.
RESULTS: Intra-operative post-procedure transesophageal echocardiogram showed a well-functioning aortic valve without insufficiency or stenosis. The patient had an uneventful post-operative hospital course and was discharged home.
CONCLUSIONS: This video demonstrates our step-by-step technique in performing a bicuspid aortic valve repair with valve-sparing root replacement.


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