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4.5
40 year-old man was presented with Marfan syndrome, enlargement of the aortic root, and mild AR. He underwent Valve-sparing aortic root replacement, VSARR, or root re-implantation technique, David procedure. Leaflet abnormalities such as large fenestrations in LCC, NCC redundancy, and tricuspid-like bicuspid valve were noted during the operation, not known preoperatively. Although leaflet tissue was frail and thin, complex cusp repairs, such as fenestration closure, central plication, and free margin re-suspension were performed. Annulus was sized 25mm, and 30mm Gelweave Valsalva, DePaulis graft, was chosen for this operation. Post-CPB AR was none-trivial, and no transfusion was required. Careful observational follow-up is mandatory for the patient, but I am cautiously optimistic that he will do well.
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