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Figure 2 Commissural Repair Maneuvers

(A) Commissural plication with a pledgeted suture (Cabrol stitch) corrects severe commissural separation and splaying, with edges of cusps approximated with figure-of-8 suture. (B) Cabrol-like stitch and figure-of-8 suture aligns commissure. (C) Reattachment or resuspension of detached commissure with a pledgeted suture on each side of commissure and plication of aortic wall with running horizontal suture above commissure. (D) Cabrol and Cabrol-like sutures at different commissural heights (high Cabrol stitches represent "classic" Cabrol stitches). Cabrol-like stitches placed lower reduce sinuses and "annulus," distort base of cusp, and narrow subcommissural triangle.