Surgical techniques
The aim of BAV repair was to reconstitute the valve’s 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.