{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T19:00:31Z","timestamp":1769281231693,"version":"3.49.0"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Aortic valve commissural avulsion is an exceptionally rare and often underdiagnosed cause of aortic regurgitation. We report a 30-year-old male with severe chronic aortic regurgitation and a mildly dilated aortic root, in whom intraoperative inspection revealed spontaneous avulsion of the right\u2013noncoronary commissure. The patient underwent valve-sparing aortic root replacement using a combined approach: remodelling root replacement with external annuloplasty according to the Lansac technique, and targeted commissural reinforcement based on David principles. Postoperative and 6-month imaging showed stable root geometry, good leaflet coaptation, mild central regurgitation, and improved left ventricular function. This case highlights the diagnostic value of multimodality imaging and illustrates that tailored application of established valve-sparing techniques can achieve durable repair in rare commissural lesions.<\/jats:p>","DOI":"10.1093\/icvts\/ivag013","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:40:35Z","timestamp":1767876035000},"source":"Crossref","is-referenced-by-count":0,"title":["Commissural Prolapse: Combining the Best From Two Aortic Valve Repair Techniques"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7551-9534","authenticated-orcid":false,"given":"Anze","family":"Djordjevic","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Medical Centre Maribor , 2000 Maribor,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Juric","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Medical Centre Maribor , 2000 Maribor,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzana","family":"Danojevic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Medical Centre Maribor , 2000 Maribor,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miha","family":"Antonic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Medical Centre Maribor , 2000 Maribor,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"2026012304323127200_ivag013-B1","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.atssr.2025.03.001","article-title":"Successful aortic valve repair for chronic aortic regurgitation due to spontaneous avulsion of the aortic valve commissure","volume":"3","author":"Wada","year":"2025","journal-title":"Ann Thorac Surg Short Rep"},{"key":"2026012304323127200_ivag013-B2","doi-asserted-by":"crossref","first-page":"ytae178","DOI":"10.1093\/ehjcr\/ytae178","article-title":"Progressive worsening of aortic regurgitation due to detachment of the aortic valve commissure with multimodality imaging to elucidate pathogenesis: a case report","volume":"8","author":"Nishino","year":"2024","journal-title":"Eur Heart J Case Rep"},{"key":"2026012304323127200_ivag013-B3","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.athoracsur.2019.03.013","article-title":"Valve-sparing aortic root replacement using the remodeling technique with aortic annuloplasty: tricuspid valves with repair of specific lesion sets: how I teach it","volume":"107","author":"Youssefi","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2026012304323127200_ivag013-B4","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0022-5223(19)34942-6","article-title":"An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta","volume":"103","author":"David","year":"1992","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026012304323127200_ivag013-B5","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3400\/avd.cr.14-00094","article-title":"Two dehiscences of the aortic valve commissure and cusp with progressive acute aortic regurgitation","volume":"8","author":"Ishii","year":"2015","journal-title":"Ann Vasc Dis"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag013\/66313652\/ivag013.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/1\/ivag013\/66313652\/ivag013.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/1\/ivag013\/66313652\/ivag013.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:32:39Z","timestamp":1769160759000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivag013\/8417671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag013","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2026,1]]},"article-number":"ivag013"}}