Unicuspid valve repair—what technique, which patch for which patient?

The unicuspid and unicommissural aortic valve (UAV) is a rare anomaly but frequently requires surgical intervention in childhood and young adulthood due to aortic stenosis, aortic regurgitation—which may become relevant after balloon/surgical valvuloplasty—and associated aortopathy. Aortic valve replacement with a mechanical prosthesis is a standard treatment in adulthood, but its results are not satisfactory in young individuals. Therefore, a reconstructive approach should be particularly attractive in the UAV. We have proposed UAV repair by bicuspidization, creating a new commissure of normal height via adding patch material and thus applying the techniques for bicuspid aortic valve repair (1-4). The details of our UAV repair are described