Minimally invasive aortic valve reconstruction with autologous pericardium: how we do it

A 22-year-old male was admitted with dyspnea on exertion due to a congenital aortic valve disease. Preoperative transthoracic echocardiography showed a severe aortic regurgitation and a quadricuspid aortic valve. The fourth cusp was aplastic, thus create a gap between the left and the non-coronary cusp, resulting in a regurgitant jet through this discontinuity. Echocardiographic examination also revealed a decreased left ventricular ejection fraction (LVEF) of 47%, left ventricular end systolic diameter was 52 mm. The diameter of the aortic annulus, sinotubular junction and ascending aorta were 30.8, 33.4 and 32.6 mm, respectively. Right ventricle contractility was normal with a tricuspid annular plane systolic excursion (TAPSE) of 22 mm and the fractional area change (FAC) of 50%. The vena contracta of the regurgitation was 6.8 mm. The patient was in New York Heart Association (NYHA) Functional Class II. On the other hand, his medical history was unremarkable