Figure 2. How to apply the additional stitch
2A: The ST-junction is smaller than annulus, and the gap is recognized below the commissure.
2B: The red arrow line is the line of sewing cuff, and the blue line is the commissure. Moreover, there was a gap in the vertical direction. The yellow arrows indicate additional stitch lines.
2C: We applied the additional stitch, which is everted an horizontal mattress suture without pledgets.