A 44-year-old male developed Stanford type A acute aortic dissection combined with bicuspid aortic valve( BAV) regurgitation. Aortic valve repair was performed by central plication and subcommissural annuloplasty. Additionally, replacement of the ascending aorta and the aortic root were performed with hemi-remodeling technique by replacing the non-coronary sinus. In this procedure, the angle of the 2 commissures were set at 180°. Postoperative transesophageal echocardiography revealed no aortic valve regurgitation. Changing the commissural orientation is considered to be important for the treatment of BAV regurgitation.

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