{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:37:02Z","timestamp":1781851022867,"version":"3.54.5"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Commissural orientation &amp;lt;160\u00b0 is a recognized risk factor for bicuspid aortic valve repair failure. Based on this observation, repairing this subtype of aortic valve by reorienting the 2 commissures at 180\u00b0 has recently been proposed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Nine porcine hearts with aortic annulus diameters of 25\u2009mm were selected. A pathological model of a Sievers 1 bicuspid aortic valve was obtained by suturing the coaptation line between the left and right leaflets. Each heart underwent reimplantation procedures both in the native (120\u00b0) and the reoriented (180\u00b0) configuration. After the operation, each sample was tested on a pulse duplicator at rest (heart rate 60 beats per min) and with mild exercise (heart rate 90 beats per min) conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>No statistically significant difference was noted in mean and peak transvalvular aortic gradients between the 2 configurations at rest (18.6\u2009\u00b1\u20095 vs 17.5\u2009\u00b1\u20094 for the mean aortic gradient; 42.8\u2009\u00b1\u200912.7 vs 36.3\u2009\u00b1\u20095.8 for the peak aortic gradient) but the group with the 120\u00b0-oriented commissures had significantly higher mean transaortic gradients compared to the group with the 180\u00b0-oriented commissures at initial exercise stress conditions (30.1\u2009\u00b1\u20099.1 vs 24.9\u2009\u00b1\u20093.8; p value 0.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The 180\u00b0 commissural reorientation of the asymmetrical bicuspid aortic valve does not improve the transvalvular aortic gradient in an acute model at rest conditions, but it could do so under stress situations. Even if it is surgically more complex and time-consuming, this approach could be a good strategy to improve long-term results, particularly in young patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab359","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T19:27:37Z","timestamp":1626809257000},"page":"647-654","source":"Crossref","is-referenced-by-count":2,"title":["Commissural repositioning in bicuspid aortic valve repair: an <i>in vitro<\/i> acute model to explore and explain different results"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9971-8845","authenticated-orcid":false,"given":"Claudia","family":"Romagnoni","sequence":"first","affiliation":[{"name":"Cardiovascular Surgery Department, ASST Fatebenefratelli Sacco, Milano, Italy"},{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Contino","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, ASST Fatebenefratelli Sacco, Milano, Italy"},{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1484-8913","authenticated-orcid":false,"given":"Michal","family":"Jaworek","sequence":"additional","affiliation":[{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"},{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rubina","family":"Rosa","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, ASST Fatebenefratelli Sacco, Milano, Italy"},{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Salurso","sequence":"additional","affiliation":[{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"},{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Perico","sequence":"additional","affiliation":[{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"},{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Gelpi","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, ASST Fatebenefratelli Sacco, Milano, Italy"},{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"},{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Vismara","sequence":"additional","affiliation":[{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"},{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco Beniamino","family":"Fiore","sequence":"additional","affiliation":[{"name":"ForcardioLab\u2014Fondazione per la Ricerca in Cardiochirurgia ONLUS, Milano, Italy"},{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mangini","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department, ASST Fatebenefratelli 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