11. VIDEO 1 SATURDAY 24 - 17.15-19.15VD08 COMMISSURAL SYMMETRIC REPOSITIONING IN BICUSPID AORTIC VALVE SPARING SURGERYContino, M.1; Romagnoni, C.1; Rosa, R.1; Mangini, A.1; Antona, C.2Author Information 1Cardiochirurgia, ASST Fatebenefratelli-Sacco Milano 2Università degli Studi di Milano Milano Journal of Cardiovascular Medicine: November 2018 - Volume 19 - Issue - p e34 doi: 10.2459/01.JCM.0000549935.00068.be Buy Metrics Abstract Particularity of the Video: Bicuspid aortic valve, the most common congenital cardiac defect, is often associated to ascending aorta and root dilation. Since commissural orientation <160° is one of the principal risk factors for recurrent aortic insufficiency, our systematic approach consists of reimplantation with 180°-180° geometric configuration associated to aortic leaflets repair. Brief Description: The valve was bicuspid due to right-left coronary cusps fusion with a fibrotic raphe. Raphe and leaflets free margin shaving was performed within the native aortic root intact to improve cusp mobility and restore a normal motion. Reimplantation procedure was performed in the conventional fashion except for the peculiarity that the valve resuspension started with fixation of the two commissures in a 180°-180° symmetric configuration within the neo-root (Valsalva graft n.28) to the new predetermined sinotubular junction. Before completion of the surgery, the valve was re-assessed to correct any residual prolapse: both leaflets needed plicature. © 2018 Italian Federation of Cardiology - I.F.C. All rights reserved.