Bicuspidization of the Unicuspid Aortic Valve by Preserving the Free Margin Tissue / 日本心臓血管外科学会雑誌

A 35-year-old man was referred to our hospital for surgical repair of grade IV/IV aortic regurgitation secondary to a congenital unicuspid aortic valve accompanied by aneurysm of the ascending aorta. The aortic valve was the unicuspid unicommissural type and a fully developed commissure was located in the left lateral position (left coronary/right coronary). The anterior (non-coronary/right coronary) and posterior (non-coronary/left coronary) borders were rudimentary with calcified raphe. We performed aortic valve repair in combination with valve sparing root replacement (reimplantation) and partial arch replacement. We converted the unicuspid into a bicuspid aortic valve by preserving his own free margin tissue and creating a neocommissure to the 180 degrees opposite side of the left lateral commissure at the same height by enlarging the cusp with a glutaraldehyde-treated autologous pericardium patch to the cusp belly. The patient was discharged on the 17th postoperative day with trace aortic regurgitation. We successfully repaired the unicuspid aortic valve by augmenting the cusp size using a pericardium patch in order to preserve the free margin of the cusp.

Echocardiography in diagnosis of congenital unicuspid aortic valve / 中国医学影像技术

Objective: To explore the value of echocardiography in diagnosis of congenital unicuspid aortic valve (UAV). Methods: Totally 20 patients with UAV diagnosed by echocardiography were retrospectively analyzed. Results: Valve dysfunction was observed in all 20 patients. Simple stenosis of aortic valve was found in 6 cases (6/20, 30.00%), while simple regurgitation was detected in 3 cases (3/20, 15.00%).Two cases (2/20, 10.00%) showed no attachment point, 18 cases (18/20, 90.00%) showed attachment point mostly located in 1-7 o'clock. The ascending aorta enlarged after narrowing in 17 cases. Nine cases were found with other congenital heart diseases, while complications were noticed in 4 cases. Conclusion: Echocardiography can diagnose congenital UAV at early stage by showing the anatomy and movement of UAV in real time, providing reliable basis for treatment and prognosis assessment.

Severe Aortic Stenosis Associated with Unicommissural Unicuspid Aortic Valve in a Middle Aged Male

Unicuspid aortic valve (UAV) is an extremely rare form of congenital aortic valvular abnormality. Although UAV shows similar clinical characteristics to bicuspid aortic valve, the clinical symptoms develop at earlier age and progress at a faster pace in UAV. In this report, we are presenting a 42-year-old male with severe aortic stenosis associated with unicommissural UAV. The patients underwent a successful Bentall operation.

Incidental Diagnosis of the Unicuspid Aortic Valve with Ascending Aortic Aneurysm in an Asymptomatic Adult

The unicuspid aortic valve is an extremely rare congenital anomaly. It usually presents with aortic stenosis and/or aortic regurgitation. Other cardiovascular complications, such as aortic dilatation and left ventricular hypertrophy can accompany it. Herein, we present a case report of a 50-year-old asymptomatic male patient with unicuspid aortic valve, complicated by ascending aortic aneurysm.

Repair of Unicuspid Aortic Valve and Mitral Valve Aneurysm Secondary Involved with Intectious Endocarditis / 日本心臓血管外科学会雑誌

A 25-year-old man with a previous diagnosis of congenital bicuspid aortic valve presented with a fever of unknown origin for 3 months. Transthoracic echocardiography revealed vegetation on the mitral valve leaflet. Transesohageal echocardiography revealed severe aortic regurgitation and a mitral valve leaflet aneurysm. Despite intensive antibiotic therapy, his clinical condition did not improve, so he underwent aortic and mitral valve repair. The aortic valve was shown to be unicuspid intraoperatively. We made a new commissure, then mitral valve aneurysm was resected and a new leaflet was made using the pericardium. There was almost no regurgitation seen on postoperative echocardiography.