Work

Commissural Prolapse: Combining the Best From Two Aortic Valve Repair Techniques

Year: 2026

Type: article

Abstract: Aortic valve commissural avulsion is an exceptionally rare and often underdiagnosed cause of aortic regurgitation. We report a 30-year-old male with severe chronic aortic regurgitation and a mildly dilated aortic root, in whom intraoperative inspection revealed spontaneous avulsion of the right-noncoronary commissure. The patient underwent valve-sparing aortic root replacement using a combined approach: remodelling root replacement with external annuloplasty according to the Lansac technique, and targeted commissural reinforcement based on David principles. Postoperative and 6-month imaging showed stable root geometry, good leaflet coaptation, mild central regurgitation, and improved left ventricular function. This case highlights the diagnostic value of multimodality imaging and illustrates that tailored application of established valve-sparing techniques can achieve durable repair in rare commissural lesions.

Source: Interdisciplinary CardioVascular and Thoracic Surgery

DOI: 10.1093/icvts/ivag013

Authors: Anze Djordjevic, Peter Juric, Suzana Danojevic, Miha Antonic

Institution: University Clinical Centre Maribor

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,258