Table 2. Lesions suitable for repair or replacement, based on valve and root anatomy and on analysis of the aortic regurgitation mechanisms by transesophageal echocardiography.

	Consider repair	Discussion with balancing of repair and replacement	Consider replacement
Valve phenotype	BAV: Type A and B	UAV
	TAV	BAV: Type C
	QAV
Root phenotype	All phenotypes
AR severity	All grades
Mechanism of AR	Type Ia–d	Type Id with large/multiple perforations	Type Id due to active endocarditis
	Type II	Type II due to large/multiple fenestrations
		Type III in young/congenital heart	Type III
Quality of cusp tissue	Flexible cusps, no SRCM	SRCM due to body calcifications (Grade 2)	Major tissue thickening
	SRCM due to root dilatation		Grade 3–4 calcifications
	SRCM due to free margin thickening		Active and destructive endocarditis
	Grade 1–2 calcifications
Specific measurements	TAV: gH >16 mm	TAV: gH ≤16 mm
	BAV: gH >19 mm (FC)	BAV: gH ≤19 mm (FC)
	Pre- and post-repair eH, cH, and CO must be compared

BAV, bicuspid aortic valve; TAV, tricuspid aortic valve; QAV, quadricuspid aortic valve; UAV, unicuspid aortic valve; AR, aortic regurgitation; SRCM, systolic restrictive cusp motion; FC, fused cusp; gH, geometric height; eH, effective height; cH, coaptation height; CO, commissural orientation.