Bicuspidization of the unicuspid aortic valve using the pericardial advancement technique

Unicuspid aortic valve (UAV) is a rare congenital defect. Compared with valve replacement, aortic valve repair is a better potential strategy to achieve a low rate of valve-related events and an enhanced quality of life. We herein report two cases of aortic valve repair for UAV accompanied by aneurysm of the ascending aorta. By retaining the free margin tissue and forming a neocommissure to the side of the left lateral commissure that is 180 degrees opposite and the same height, we were able to achieve bicuspidization of the UAV. A glutaraldehyde-treated autologous pericardium patch was placed along the cusp connection to the annulus to expand the aortic cusp. During the follow-up period of over 4 years, the patients showed no signs of aortic regurgitation or significant stenosis.