1. Aortic Valve Insufficiency: Leaflet Reconstruction Techniques
Joel Price, Gebrine El Khoury 
Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 
Volume 15, Issue 1, Pages 3-8 (January 2012)
DOI: /j.pcsu
Copyright © 2012 Elsevier Inc. Terms and Conditions

2. Figure 1
Technique for free margin central plication. A, Placement of the reference suture. B, Placement of the free margin plication suture. C, Plication of the body of the leaflet from base of the fold to the free margin. D, Final appearance after repair.
Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual  , 3-8DOI: ( /j.pcsu )
Copyright © 2012 Elsevier Inc. Terms and Conditions

3. Figure 2
Triangular resection performed by grasping the apex of the fold at the free margin with forceps and cutting with scissor blades maintained parallel to the plane of the leaflet tissue.
Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual  , 3-8DOI: ( /j.pcsu )
Copyright © 2012 Elsevier Inc. Terms and Conditions

4. Figure 3
Technique for reconstruction of a bicuspid valve using a triangular pericardial patch. A, Demonstration of the appropriate size of the patch by fixing the leaflet to the reference leaflet. B, Completed patch repair.
Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual  , 3-8DOI: ( /j.pcsu )
Copyright © 2012 Elsevier Inc. Terms and Conditions

5. Figure 4
Commissural reconstruction in a bicuspid valve. A, Resection of the diseased pseudocommissure. B, A strip of bovine pericardium is folded in half and attached to the aortic wall at the same height as the true commissure. C, The patch is attached to the residual aortic leaflets on either side. D, Final appearance of the reconstructed commissure.
Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery Annual  , 3-8DOI: ( /j.pcsu )
Copyright © 2012 Elsevier Inc. Terms and Conditions