Surgical techniques
The aim of BAV repair was to reconstitute the valveās normal geometry
and function. Valve repair was performed only in patients with delicate
leaflets without calcification or postendocarditic defects. Therefore,
accurate preoperative echocardiography with precise evaluation of cusp
quality and intraoperative inspection of the aortic cusps were
essential. The ascending aorta and right atrium were cannulated for
cardio-pulmonary bypass (CPB), respectively bicaval venous cannulation
was applied in concomitant mitral or tricuspid valve procedures. The
right axillary artery was cannulated for CPB in patients who underwent
additional aortic arch replacement. The aorta was cross-clamped, a
transverse aortotomy was performed and cold blood cardioplegia was
administered selective through the coronary ostia.