Sub-Commissural Annuloplasty (SCAP)
SCAP consisted of one or two sub-commissural triangle plications (Figure 1), performed by X-stitches using braided Ethibon 2/0: the first one was usually placed under the commissure between the left coronary (LC) and non-coronary (NC) cusps, eventually completed by additional sutures under the commissure between the NC and the right coronary (RC) cusps or the LC and RC cusps. Thus, SCAP permits to reduce slightly the size of the aortic annulus, to circularize an elliptic annulus or to reshape the annulus in the horizontal plane by reducing discrepancies between sub-commissural triangle heights.