FIGURE 1.

A, A “Y” incision through the left-non commissure post extended below the aortic annulus to the area between the nadirs of left and noncoronary cusps and mitral valve annulus for the aortic root enlargement. B, The aortic root was wide open after the Y incision (white arrow). Yellow arrow shows the left coronary ostium. C, In the left panel, a rectangular patch was sewn to the mitral annulus (white arrow) at the bottom and aortic annulus (white stars) on both sides, then to the incision of the transverse aortotomy. Yellow arrow shows left coronary ostium. In the right panel, an illustration of the suture lines of the anastomosis of the Dacron patch to the mitral and aortic annulus.