Bicuspidization of the regurgitant unicuspid aortic valve.

Unicuspid anatomy of the aortic valve is an infrequent variant, but may require surgery early in life for regurgitation. We have developed a repair technique that converts the unicuspid into a bicuspid aortic valve and is applicable in most patients. The repair strategy focuses on the creation of a symmetric bicuspid aortic valve with two normal commissures. Abnormal cusp tissue is divided or partially resected. Using autologous pericardium the cusps are augmented and a second normal commissure created. We have been able to use this approach in all regurgitant unicuspid aortic valves. Freedom from reoperation at five years is 80%, freedom from valve replacement at five years is 92%.