- Academic Editors
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†These authors contributed equally.
Background: The ideal position of suture annuloplasty relative to the
aortic annulus (internal or external) remains unclear. This study aimed to
investigate the effectiveness of internal and external suture annuloplasty for
isolated type 1 bicuspid aortic valve (BAV) repair. Electrocardiogram (ECG)-gated
computed tomography (CT) was used to compare the two techniques and analyze their
impact on the aortic annulus. Methods: We retrospectively analyzed 20
patients who underwent isolated type 1 BAV repair with either internal or
external suture annuloplasty. Each group included 10 patients with comparable
clinical features. Preoperative and postoperative ECG-gated CT scans were
performed to assess the anatomical relationship between the ventricular-aortic
junction (VAJ) and virtual basal ring (VBR), and to measure the height of
annuloplasty from the VBR at predefined landmarks in both groups. Perioperative
annular geometries, including annular area and perimeter, were measured to
quantify the impact of annuloplasty on annular expansibility. The discrepancy
between the postoperative annular dimension and size of the Hegar dilator were
compared between groups to evaluate the effectiveness of annuloplasty.
Results: In both groups, VAJ was higher than VBR at the right coronary
(RC) ostium (7.7