Assessment and repair of aortic valve cusp prolapse: Implications for valve-sparing procedures Munir Boodhwani, MD, MMSc, Laurent de Kerchove, MD, Christine.

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Assessment and repair of aortic valve cusp prolapse: Implications for valve-sparing procedures Munir Boodhwani, MD, MMSc, Laurent de Kerchove, MD, Christine Watremez, MD, David Glineur, MD, Jean-Louis Vanoverschelde, MD, Philippe Noirhomme, MD, Gebrine El Khoury, MD The Journal of Thoracic and Cardiovascular Surgery Volume 141, Issue 4, Pages 917-925 (April 2011) DOI: 10.1016/j.jtcvs.2010.12.006 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Transesophageal echocardiographic views of the aortic valve in long axis (A), demonstrating an eccentric aortic insufficiency jet. B, Cusp prolapse with coaptation below the level of the aortic annulus and a fibrous band (white arrow). C, A short-axis view of the aortic valve confirms the presence of the fibrous band (white arrow). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 917-925DOI: (10.1016/j.jtcvs.2010.12.006) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 After a transverse aortotomy, cusp inspection reveals a transverse fibrous band on the prolapsing cusp indicated by the black arrow. Right coronary cusp (A and B) and noncoronary cusp (C). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 917-925DOI: (10.1016/j.jtcvs.2010.12.006) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Freedom from (A) aortic valve (AV) reoperation and (B) recurrent aortic insufficiency (AI) greater than 2+ in the isolated and associated groups. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 917-925DOI: (10.1016/j.jtcvs.2010.12.006) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions