{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:31:32Z","timestamp":1788780692886,"version":"build-2803163510"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,3,2]],"date-time":"2019-03-02T00:00:00Z","timestamp":1551484800000},"content-version":"vor","delay-in-days":1,"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":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>We sought to investigate cusp size limitations for valve repair in patients with aortic regurgitation (AR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Preoperative computed tomography was performed in 105 patients. Cusp geometric height (GH) and annulus size were measured. Mean patient age was 60.7\u2009\u00b1\u200913.7\u2009years. Mean GH of 3 cusps was used in the analysis. Annulus cusp mismatch was graded using predicted coaptation length. Patients were categorized by mean GH into group S (GH &lt;16\u2009mm; n\u2009=\u200935) or L (GH \u226516\u2009mm; n\u2009=\u200970).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Preoperative mean GH was 17.1\u2009\u00b1\u20092.3\u2009mm. GH and body height were significantly correlated (r\u2009=\u20090.61). Intraoperative mean GH (18.8\u2009\u00b1\u20092.2\u2009mm) was larger than preoperative mean GH (P\u2009&lt;\u20090.0001). However, postoperative (17.1\u2009\u00b1\u20092.0\u2009mm) and preoperative mean GH did not differ. Moderate AR was not present on predischarge echocardiography. Mild AR was observed in 51% and 17% of patients in groups S and L, respectively (P\u2009=\u20090.006). During follow-up, moderate or severe AR was observed in 14% and 10% of patients in groups S and L, respectively (P\u2009=\u20090.74). Two patients in group S required reoperation for a regurgitant valve. Twenty (83%) and 15 (21%) patients in groups S and L, respectively, had severe annulus cusp mismatch before surgery. Annulus cusp mismatch resolved in most patients in group L postoperatively, whereas more than half the patients in group S still had severe mismatch.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Small cusp size (GH &lt;16\u2009mm) is not necessarily a contraindication in aortic valve repair. However, most patients in this group had annulus cusp mismatch. Root replacement or secure annulus plication is mandatory to correct annulus cusp mismatch.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezz053","type":"journal-article","created":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T04:19:07Z","timestamp":1550463547000},"page":"497-502","source":"Crossref","is-referenced-by-count":27,"title":["Is small cusp size a limitation for aortic valve repair?\u2020"],"prefix":"10.1093","volume":"56","author":[{"given":"Tatsuhiko","family":"Komiya","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Shimamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihito","family":"Nonaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,1]]},"reference":[{"key":"2019091011542092000_ezz053-B1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jtcvs.2012.06.053","article-title":"Cusp height in aortic valves","volume":"146","author":"Sch\u00e4fers","year":"2013","journal-title":"J Thorac Cardiovasc 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