Severe Pulmonary Valve Incompetence Late After Debanding: Repair by Bicuspidization Engin Usta, MD, Renate Kaulitz, MD, PhD, Shahriar Salehi-Gilani,

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Severe Pulmonary Valve Incompetence Late After Debanding: Repair by Bicuspidization Engin Usta, MD, Renate Kaulitz, MD, PhD, Shahriar Salehi-Gilani, MD, Michael Hofbeck, MD, PhD, Gerhard Ziemer, MD, PhD The Annals of Thoracic Surgery Volume 86, Issue 1, Pages 295-297 (July 2008) DOI: 10.1016/j.athoracsur.2007.12.080 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Preoperative angiography shows the pulmonary annulus diameter is 35 mm and the pulmonary trunk is 55 mm. The right ventricular outflow tract (RVOT) is also massively enlarged. (Right ventricle, 1; RVOT, 2; pulmonary annulus, 3; pulmonary trunk, 4.) (B) The 1-month follow-up angiography shows the obvious reduction of the monstrous pulmonary trunk, which now has a 33-mm diameter. The diameter of the pulmonary annulus now is about 22 mm. The bar (arrow) indicates 10 mm. The contour of the RVOT and pulmonary trunk is marked with a gray line. The Annals of Thoracic Surgery 2008 86, 295-297DOI: (10.1016/j.athoracsur.2007.12.080) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) A preoperative computed tomography (CT) scan shows the diameter of the pulmonary trunk is 55 mm. (B) The 3-month postoperative CT scan shows the diameter of the reduced pulmonary trunk maintained constant at 33 mm. Each picture contains a 50-mm scale. (Aorta ascendens, 1; pulmonary trunk, 2; left main pulmonary artery, 3.) The Annals of Thoracic Surgery 2008 86, 295-297DOI: (10.1016/j.athoracsur.2007.12.080) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Diameters of the pulmonary annulus and trunk at the 9-month follow-up are visualized by cardiac magnetic resonance imaging. (A) Sagittal slice presents the right ventricular outflow tract (RVOT), pulmonary annulus, and pulmonary trunk. Line 1 indicates the diameter of the pulmonary annulus is 21.98 mm. (B) An axial slice features the pulmonary annulus and pulmonary trunk. Line 1 indicates the diameter of the pulmonary annulus is 22.52 mm. Line 2 marks the diameter of the pulmonary trunk, just before the bifurcation. A 50-mm scale is given in each panel. (Ao = aorta ascendens; LPA = left pulmonary artery; PA = pulmonary artery.) The Annals of Thoracic Surgery 2008 86, 295-297DOI: (10.1016/j.athoracsur.2007.12.080) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions