Successful Tricuspidization of Bicuspid Aortic Valve Complicated by Anomalous Coronary Artery

Repair of an asymmetrical bicuspid aortic valve remains a complicated endeavor. Here, we present a successful aortic valve repair for severe aortic regurgitation associated with such a bicuspid aortic valve, further complicated by an anomalous coronary artery. The nonsevered dilated aortic root was reshaped by the sleeve procedure with a Valsalva graft, and the raphe was lifted up to reconstruct the functional commissure, which enabled tricuspidization. Correcting the anomalous aortic origin of the right coronary artery, which posed a risk of myocardial ischemia because of its interarterial course, was achieved by translocating it to the right sinus of Valsalva.