Describes a surgical technique combining internal and external annuloplasty for functional aortic annulus 3-dimensional remodelling during bicuspid aortic valve repair.
May guide annuloplasty selection in BAV repair; leaves open durability and outcome validation.
The internal geometric ring provides full three-dimensional annular stability while minimizing the dissection of the aortic root, pulmonary artery and right ventricle and avoids reimplanting the coronaries. The external annuloplasty provides a secondary stabilization of the easily accessed fibrous portion of the annulus using the sutures for the internal annuloplasty device and minimizes the sutures above the leaflets. Together they form a complete remodelling of the ventriculo-aortic junction following its exact course. The junction together with stabilization of the subcommissural triangles defines functional aortic annulus remodelling. External annuloplasty supports the virtual basal ring.
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Jasiński et al. (2023) studied this question.
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