Aortic valve insufficiency due to aortic dilatation: correction by sinus rim adjustment.

Idiopathic dilatation of the aortic root may commonly cause chronic insufficiency of the aortic valve. In these patients the cusp and sinuses are normal or virtually normal in area and pliability and the coronaries are not displaced. The insufficiency in these patients may be totally corrected by an adjustment of the intercommissural distance at the sinus rim level. The dilated ascending aorta is dealt with separately by whatever technique is appropriate. Five patients with aortic insufficiency due to idiopathic ascending aorta dilatation are described. All underwent successful correction of the insufficiency by adjustment of the intercommissural distance at the sinus rim level and thus far the correction has been maintained for up to 16 months after surgery in each.