Fig. 2

Operative findings. (a) Transesophageal echocardiography shows an inversion of the aortic flap into the left ventricular outflow tract. (b, c) The dynamic obstruction of the left main trunk (LMT) was repaired by repositioning the aortic flap. (d) Proximal reinforcement was performed with a Teflon felt inside and outside using continuous mattress sutures