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Updated: Oct 3, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Unicuspid Aortic Valve Presenting With Severe Aortic Regurgitation and Successfully Repaired by Bicuspidization
Naoko Soejima1, Hidekazu Tanaka1, Tatsuya Miyoshi1
1Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Sakai, Osaka, Japan.
Background:
Unicuspid aortic valve (UAV) is a rare congenital anomaly and is often misdiagnosed as a bicuspid aortic valve (BAV). It typically presents with aortic stenosis rather than regurgitation.
Case Summary:
A 21-year-old man presented with exertional dyspnea and was diagnosed with severe aortic regurgitation (AR) and aortic root dilation. He had been followed as having BAV since childhood. However, transesophageal echocardiography revealed a unicommissural UAV. The patient underwent valve-sparing aortic root replacement using the reimplantation technique combined with bicuspidization. Postoperative echocardiography showed mild residual AR with good valve function.
Discussion:
UAV is frequently misdiagnosed on transthoracic echocardiography, and its presentation with severe AR is uncommon. This case highlights the diagnostic value of transesophageal echocardiography and the feasibility of valve-sparing surgery in selected young patients.
Take-Home Messages:
UAV may be overlooked as BAV and can present with severe AR. Accurate diagnosis and valve-sparing surgery are key in young patients.
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