Modified patch repair for bicuspid aortic valve with thickened raphe.

We report a successful repair of bicuspid aortic valve having thickened raphe using pericardial patch. After excising the thickened portion, the patch was sewn to the remaining leaflet and root. To note, the height the patch was sewn to the root was lowered to the equivalent level of the corresponding portion of the other cusp, to create symmetrical bicuspid configuration. Postoperative echocardiography revealed trivial aortic regurgitation with improved leaflet motion and transvalvular flow.