case_images: PMC9110680_01
case_images: (A) Pre-operation: quadricuspid aortic valve (QAV). (B) Post-operation: QAV to tricuspidization aortic valve (TAV). (C) Transthoracic echocardiogram (TTE) demonstrated severe regurgitation before operation. (D) Post-operation image of transesophageal echocardiography (TEE) showed no regurgitation.
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case_images: F1
case_images: TEE showed that the residual three cusps functioned well without regurgitation or stenosis (Figures 1B,D).
case_images: (A) The pre-op CT angiography (CTA) showed ascending aortic aneurysm of 47.9 mm. (B) The post-op CTA scan showed normal ascending aortic size.
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case_images: F2
case_images: Type B QAV with a dilated ascending aorta of 47.9 mm (Figure 2A). TTE found that the left ventricular end-diastolic diameter was 77 mm and had a reduced ejection fraction of 39%. A short-term follow-up of 12 months showed no recurrence of AI, and the aortic aneurysm was resolved (Figure 2B).
case_images: (A) Resect the aortic tissue from sinotubular junction (STJ) downwards to the sinus nadir of the smallest cusps. (B) Resect the smallest cusp. (C) Reconstruct the root by a horizontal running mattress suture. (D) Utilizing a 24-mm Dacron graft to replace the ascending aortic aneurysm.
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case_images: PMC9110680_01_fcvm-09-871818-g0003.jpg
case_images: F3
case_images: Finally, a 24-mm Dacron graft was used to replace the ascending aorta (all the main surgical steps are shown in Figure 3).