Valve-sparing aortic root replacement for a prolapsing asymmetric valve.

Valve-sparing aortic root replacement remains challenging for patients with eccentric severe aortic regurgitation when the cusps are totally asymmetric. We report a case of successful reimplantation operation for such a lesion. Because free margin lengths from commissure to Arantius body of the adjacent two cusps were matched while inter-commissural distances were totally different, right coronary cusp prolapse was corrected by asymmetrically aligning the position and height of three commissures without cusp plication.