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Bicuspidization of the Unicuspid Aortic Valve: A New Reconstructive Approach  Hans-Joachim Schäfers, MD, Diana Aicher, MD, Svetlana Riodionycheva, MD,

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Presentation on theme: "Bicuspidization of the Unicuspid Aortic Valve: A New Reconstructive Approach  Hans-Joachim Schäfers, MD, Diana Aicher, MD, Svetlana Riodionycheva, MD,"— Presentation transcript:

1 Bicuspidization of the Unicuspid Aortic Valve: A New Reconstructive Approach 
Hans-Joachim Schäfers, MD, Diana Aicher, MD, Svetlana Riodionycheva, MD, Angelika Lindinger, MD, Tanja Rädle-Hurst, MD, Frank Langer, MD, Hashim Abdul-Khaliq, MD  The Annals of Thoracic Surgery  Volume 85, Issue 6, Pages (June 2008) DOI: /j.athoracsur Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Schematic drawing of aortic cusp insertion lines of (A) a unicuspid vs (B) a bicuspid aortic valve. (LC = left coronary cusp; NC = noncoronary cusp; RC = right coronary cusp.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Schematic drawing of a typical unicuspid aortic valve as seen by the surgeon. The posterior commissure is of normal height, and the anterior (rudimentary) commissure is abnormally low. The commissure between rudimentary right and left cusps is also lower than normal. These two rudimentary commissures are lower than the coronary ostia. (ANT = anterior; LCO = left coronary ostium; RCO = right coronary ostium.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 The fused cusp tissue is incised towards the anterior commissure and then detached from the aortic insertion for a few millimeters along the dotted lines. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 For reconstruction using pericardial patches, the suture lines (straight line) in the anterior aortic root will curve cranially to create a second commissure of normal height. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 The cusps are augmented with triangular pieces of pericardium (shaded) reaching from native cusp tissue to the new commissure. The result is a bicuspid aortic valve with 2 commissures of normal height. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

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