Tricuspidization of the Bicuspid Aortic Valve With Aortic Regurgitation

To describe the technique of tricuspidization of the bicuspid aortic valve.

Six patients with very asymmetrical aortic cusp and 3 sinuses had tricuspidization. Mean age was 32.2 years, and all had severe aortic regurgitation (AR). The fused valve was right + left in 5, and right + noncoronary cusp in 1; commissure angle of the non-fused cusp was 130°-140°. Cusp geometric height was 20.3 mm, basal ring diameter was 29.5 mm. Central portion of the fused cusp was elevated to the same level of the other commissures. All had resuspension of the nonfused cusp.

No early or late death was observed. Cardiac ischemia was 173 minutes. Postoperative AR was trace in 2, and mild in 4. Follow-up duration was 5 to 34 months. AR was trace in 1, mild in 4, and moderate in 1. Mean pressure valve gradient was 6.9 mm Hg, and valve orifice area was 2.10 cm².

Early outcomes of tricuspidization of bicuspid aortic valve were acceptable in selected patients with suitable anatomies.