Figure 5.

A, The aortic root is dissected to the root insertion plane into the ventricular muscle. The pathologic aortic root is resected with the coronary buttons harvested and retracted. B, Symmetric suspension of the commissures may reveal a prolapsed cusp. C, The commissures can be subsequently rotated, with simultaneous height adjustment to correct cusp prolapse. D, Type I bicuspid aortic valve can be successfully repaired using the valve-sparing root replacement technique by creating a 170°/190° commissural orientation.