Table 1.

BAV phenotypes, anatomy, pathophysiology, and surgical approach

BAV phenotype	Commissural orientation	Raphe height	Cusp fusion	Prolapse	Repair
True symmetric	180°	None	Complete	None∗, 1, or 2 cusps	Cusp plication(s), 180° repair
Symmetric	160°-180°	Close to BR	Long fusion	Fused cusp	Cusp plication, 180° repair
Asymmetric	140°-159°	Below STJ	Short fusion	Fused cusp	Raphe thinning, direct raphe closure, 180° repair
Very asymmetric	120°-139°	Close to STJ	Very short fusion	Fused cusp	Tailored approach
Fruste	120°-139°	At STJ	Very short fusion	Fused cusp	Commissurotomy, commissure resuspension, commissure reconstruction with patch
Fenestrated/Chordal raphe	120°-139°	Close to or at STJ	Short fusion	Fused cusp	Cord resection, direct raphe closure, 180° repair

BAV, Bicuspid aortic valve; BR, basal ring; STJ, sinotubular junction.

^∗In case of root aneurysm without AR, the valve phenotype is generally a true BAV.