{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:16:31Z","timestamp":1736918191940,"version":"3.33.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Gen Thorac Cardiovasc Surg Cases"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Repair of the regurgitant bicuspid aortic valve is an attractive alternative to valve replacement. Although good long-term outcomes have been reported, postoperative aortic stenosis remains a major late cause of repair failure in bicuspid aortic valves. Sinus plication is effective for creating a more symmetrical commissural angle, leading to a decrease in the mean transvalvular pressure gradient. Herein, we report a successful case of aortic valve repair with sinus plication for a regurgitant bicuspid aortic valve.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>The patient was a 34-year-old man with bicuspid aortic valve, severe aortic regurgitation, and left ventricular dilatation. Echocardiography revealed an eccentric aortic regurgitation jet caused by a fused cusp prolapse. The commissural angle was approximately 136\u00b0, classified as asymmetrical. The patient underwent surgery via median sternotomy. Cardiopulmonary bypass was initiated using the ascending aortic and single two-stage atrial cannulation with left ventricular venting via the right superior pulmonary vein. After the ascending aorta was cross-clamped, transection was performed 5\u201310\u00a0mm above the sinotubular junction. Based on the valve configuration, annuloplasty, sinus plication, and ascending aortic replacement were planned in addition to triangular resection of the bulking raphe tissue with central cusp plication. Mattress sutures of 4\u20130 polypropylene, reinforced with autologous pericardium, were placed outside the fused cusp for sinus plication. The sutures extended from the basal ring to the sinotubular junction, reducing the sinus circumference by approximately 15\u00a0mm. Intraoperative transesophageal echocardiography revealed trivial aortic regurgitation and modified commissural angulation. The operation, cardiopulmonary bypass, and aortic cross-clamping times were 311, 129, and 95\u00a0min, respectively.<\/jats:p>\n            <jats:p>The clinical course was uneventful, without major complications. Postoperative echocardiography demonstrated an improved commissural angle. Follow-up echocardiography demonstrated trivial aortic regurgitation and a decreased mean transvalvular pressure gradient.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Sinus plication may be one of the most effective repair techniques for asymmetrical bicuspid aortic valves, especially in cases without Valsalva sinus dilation. This technique helps avoid postoperative aortic valve stenosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s44215-024-00184-0","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T09:37:09Z","timestamp":1736847429000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aortic valve repair with sinus plication for a regurgitant bicuspid aortic valve: a case report"],"prefix":"10.1186","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4321-2762","authenticated-orcid":false,"given":"Atsutaka","family":"Aratame","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kunihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshio","family":"Baba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Sakaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Sumii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikado","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"issue":"2","key":"184_CR1","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1161\/CIRCULATIONAHA.109.934679","volume":"123","author":"D Aicher","year":"2011","unstructured":"Aicher D, Kunihara T, Abou Issa O, Brittner B, Gr\u00e4ber S, Sch\u00e4fers HJ. Valve configuration determines long-term results after repair of the bicuspid aortic valve. Circulation. 2011Jan 18;123(2):178\u201385.","journal-title":"Circulation"},{"issue":"19","key":"184_CR2","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.1056\/NEJMoa1613792","volume":"377","author":"AB Goldstone","year":"2017","unstructured":"Goldstone AB, Chiu P, Baiocchi M, Lingala B, Patrick WL, Fischbein MP, et al. Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement. N Engl J Med. 2017Nov 9;377(19):1847\u201357.","journal-title":"N Engl J Med"},{"issue":"4","key":"184_CR3","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/j.athoracsur.2020.04.146","volume":"111","author":"SH Patlolla","year":"2021","unstructured":"Patlolla SH, Schaff HV, Stulak JM, Michelena HI, Saran N, King KS, Dearani JA. Bicuspid aortic valve repair: causes of valve failure and long-term outcomes. Ann Thorac Surg. 2021Apr;111(4):1225\u201332.","journal-title":"Ann Thorac Surg"},{"key":"184_CR4","doi-asserted-by":"crossref","unstructured":"Ehrlich T, Abeln KB, Froede L, Schmitt F, Giebels C, Sch\u00e4fers HJ. Twenty-five years\u2019 experience with isolated bicuspid aortic valve repair: impact of commissural orientation. Eur J Cardiothorac Surg. 2024;65(4):ezae163.","DOI":"10.1093\/ejcts\/ezae163"},{"key":"184_CR5","first-page":"30","volume":"2","author":"HA Vohra","year":"2013","unstructured":"Vohra HA, Whistance RN, de Kerchove L, Glineur D, Noirhomme P, El Khoury G. Influence of higher valve gradient on long-term outcome after aortic valve repair. Ann Cardiothorac Surg. 2013;2:30\u20139.","journal-title":"Ann Cardiothorac Surg"},{"issue":"2","key":"184_CR6","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.athoracsur.2016.06.064","volume":"103","author":"U Schneider","year":"2017","unstructured":"Schneider U, Schmied W, Aicher D, Giebels C, Winter L, Sch\u00e4fers HJ. Sinus plication to improve valve configuration in bicuspid aortic valve repair-early results. Ann Thorac Surg. 2017Feb;103(2):580\u20135.","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"184_CR7","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1093\/ejcts\/ezab115","volume":"60","author":"S Arimura","year":"2021","unstructured":"Arimura S, Takada J, Nishimura G, Nakama N, Kawasaki E, Matsuhama M, et al. The efficacy of sinus plication in aortic valvuloplasty for bicuspid aortic valve: experiments in a pulsatile flow simulation model. Eur J Cardiothorac Surg. 2021Oct 22;60(4):859\u201364.","journal-title":"Eur J Cardiothorac Surg"},{"key":"184_CR8","doi-asserted-by":"publisher","first-page":"e383","DOI":"10.1016\/j.jtcvs.2021.06.019","volume":"162","author":"HI Michelena","year":"2021","unstructured":"Michelena HI, Della Corte A, Evangelista A, Maleszewski JJ, Edwards WD, Roman MJ, et al. International consensus statement on nomenclature and classification of the congenital bicuspid aortic valve and its aortopathy, for clinical, surgical, interventional and research purposes. J Thorac Cardiovasc Surg. 2021;162:e383\u2013414.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"184_CR9","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1016\/j.athoracsur.2015.07.068","volume":"101","author":"U Schneider","year":"2016","unstructured":"Schneider U, Aicher D, Miura Y, Sch\u00e4fers HJ. Suture annuloplasty in aortic valve repair. Ann Thorac Surg. 2016Feb;101(2):783\u20135.","journal-title":"Ann Thorac Surg"},{"issue":"1","key":"184_CR10","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.jtcvs.2015.04.020","volume":"150","author":"EH Stephens","year":"2015","unstructured":"Stephens EH, Hope TA, Kari FA, Kvitting JP, Liang DH, Herfkens RJ, et al. Greater asymmetric wall shear stress in Sievers\u2019 type 1\/LR compared with 0\/LAT bicuspid aortic valves after valve-sparing aortic root replacement. J Thorac Cardiovasc Surg. 2015Jul;150(1):59\u201368.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["General Thoracic and Cardiovascular Surgery Cases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44215-024-00184-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s44215-024-00184-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44215-024-00184-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T09:37:12Z","timestamp":1736847432000},"score":1,"resource":{"primary":{"URL":"https:\/\/gtcscases.biomedcentral.com\/articles\/10.1186\/s44215-024-00184-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,14]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["184"],"URL":"https:\/\/doi.org\/10.1186\/s44215-024-00184-0","relation":{},"ISSN":["2731-6203"],"issn-type":[{"value":"2731-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,14]]},"assertion":[{"value":"8 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"A written informed consent was obtained from the patient for the publication of this case report and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3"}}