Crescent plication of the aortic sinuses of Valsalva

ObjectiveThe study objective was to describe our experience of performing the relatively simple technique of crescent plication of one or more sinus of Valsalva in various clinical scenarios as an alternative to root replacement and to assess the mid to long term results.MethodsFrom 2006 to 2016 17 patients underwent crescent plication of one or more aortic sinuses in association with other procedures 12 had trileaflet aortic valve (group one) four had bicuspid aortic valve (group two) in addition there was a single patient with Marfan syndrome who presented with acute type A aortic dissection.ResultsCrescent plication resulted in a moderate reduction in root diameter that has remained stable over the study period apart from the Marfan patient who unsurprisingly showed modest root dilation over time.ConclusionsCrescent plication is a relatively simple procedure that reduced root diameter and appears to be stable over time in all but the syndromic patient and can be a viable alternative in situations where full root replacement is judged hazardous.