case_images: PMC11731531_01
case_images: Preoperative echocardiography showing the prolapsed fused cusp, eccentric jet, and severe aortic regurgitation
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case_images: PMC11731531_01_44215_2024_184_Fig1_HTML.jpg
case_images: Fig1
case_images: Echocardiography revealed an eccentric AR jet caused by a fused cusp prolapse (Fig. 1), with a mean transvalvular pressure gradient of 18.0 mmHg.
case_images: Preoperative contrast-enhanced computed tomography and transesophageal echocardiography showing the commissural angle of approximately 136 . The commissural angle was measured by using transesophageal echocardiography on short-axis view. Each line is drawn from the center of cusp coaptation to the two commissures
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case_images: PMC11731531_01_44215_2024_184_Fig2_HTML.jpg
case_images: Fig2
case_images: The commissural angle was approximately 136 , and the fusion leaflet of the left and right cusps was classified as very asymmetrical (Fig. 2).
case_images: Two mattress sutures of 4-0 polypropylene, reinforced with autologous pericardium, were placed outside the fused cusp halfway from the basal ring to near the STJ
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case_images: PMC11731531_01_44215_2024_184_Fig3_HTML.jpg
case_images: Fig3
case_images: Two mattress sutures of 4-0 polypropylene, reinforced with autologous pericardium, were placed outside the fused cusp from the basal ring to near the STJ, reducing the sinus circumference by approximately 15 mm (Fig. 3).
case_images: Postoperative contrast-enhanced computed tomography and transesophageal echocardiography demonstrating an increased commissural angle by approximately 20
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case_images: Fig4
case_images: Postoperative contrast-enhanced computed tomography and transesophageal echocardiography showed an improved commissural angle (Fig. 4).
case_images: Postoperative echocardiography demonstrating trivial aortic regurgitation
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case_images: PMC11731531_01_44215_2024_184_Fig5_HTML.jpg
case_images: Fig5
case_images: AR (Fig. 5), and the mean transvalvular pressure gradient was 14.8 mmHg. At the 3-month follow-up, echocardiography demonstrated a substantial reduction in left ventricular volume and an improved left ventricular ejection fraction.