Bicuspid aortic valve repair with external annuloplasty

This video tutorial demonstrates the surgical repair of a bicuspid aortic valve in a 45-year-old male patient with severe aortic regurgitation due to annular dilatation and prolapse of the fused cusp. The procedure included external annuloplasty to stabilize and downsize the annulus, and cusp plication to restore effective height and durable coaptation. The repair resulted in a competent native valve with preserved geometry. It highlights reconstructive strategies as a durable alternative to valve replacement.