Introduction
Ozaki procedure aims to reconstruct patients’ aortic valve using autologous pericardium, offering an alternative treatment to classic AVR. Since its first description by Ozaki, AVNeo has yielded promising results in adult populations worldwide, either in presence of bicuspid or tricuspid aortic valve. [1, 2].
With respect to the tricuspid phenotype, it has been recommended that if the difference between the sizing of each cusps is more than 2 mm, a new commissure should be created to prevent misalignment between the cusps [3]. However, re-locating a commissure could be technically challenging.
Hereafter we describe our original “P-stich technique” which allows to downsize the intercommisural distance in a tricuspid valve and thereby achieve valvular symmetry during AVNeo avoiding the shifting of a commissure from its natural position.