Unicuspid Aortic Valve Repair Using Geometric Ring Annuloplasty

BackgroundUnicuspid aortic valves (Sievers type 2 bicuspid) are characterized by major fusion and clefting of the right-left coronary commissure, minor right-noncoronary commissure. Repair has been difficult because two fusions, variable relative sinus sizes, peripheral leaflet deficiencies or tears after balloon valvuloplasty.MethodsTwenty unicuspid patients underwent valve repair in nine institutions. Right-left occurred 17 20 (85%). Commissurotomy was performed on fusion, a bicuspid annuloplasty ring with circular base geometry 180-degree subcommissural posts sutured beneath annulus, equalizing annular circumferences fused nonfused cusps. The plicated, cleft closed linearly until effective heights lengths became greater than 8 mm equal, respectively.ResultsAverage age (mean ± SD) 22.3 12.3 years (range, 13 to 58), 12 (60%) were symptomatic, 10 (50%) required aneurysm resection. Pre-repair hemodynamic data included mean systolic gradient 25.8 12.9 Hg, insufficiency grade 2.9 1.2, diameter 24.7 3.3 mm. No mortality complications occurred. Post-repair (ring) size 20.5 1.3 mm, fell 16.2 5.9 decreased 0.1 0.3 (P < .001). At an average follow-up 11 months 1 22), all asymptomatic had returned full activity.ConclusionsAortic reduced effectively, recruiting more midline coaptation. Minor commissurotomy remodeling commissures converted UAV simple reproducible procedure. Unicuspid valvuloplasty. Twenty respectively. Average activity. Aortic