PMC9110680_01
(A) Pre-operation: quadricuspid aortic valve (QAV). (B) Post-operation: QAV to tricuspidization aortic valve (TAV). (C) Transthoracic echocardiogram (TTE) demonstrated severe regurgitation before operation. (D) Post-operation image of transesophageal echocardiography (TEE) showed no regurgitation.
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F1
TEE showed that the residual three cusps functioned well without regurgitation or stenosis (Figures 1B,D).
(A) The pre-op CT angiography (CTA) showed ascending aortic aneurysm of 47.9 mm. (B) The post-op CTA scan showed normal ascending aortic size.
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F2
Type B QAV with a dilated ascending aorta of 47.9 mm (Figure 2A). TTE found that the left ventricular end-diastolic diameter was 77 mm and had a reduced ejection fraction of 39%. A short-term follow-up of 12 months showed no recurrence of AI, and the aortic aneurysm was resolved (Figure 2B).
(A) Resect the aortic tissue from sinotubular junction (STJ) downwards to the sinus nadir of the smallest cusps. (B) Resect the smallest cusp. (C) Reconstruct the root by a horizontal running mattress suture. (D) Utilizing a 24-mm Dacron graft to replace the ascending aortic aneurysm.
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F3
Finally, a 24-mm Dacron graft was used to replace the ascending aorta (all the main surgical steps are shown in Figure 3).