Naimo and colleagues1 present their review of patients with truncal root dysfunction who underwent truncal root remodeling. The main finding of the study is that tricuspidization-type reconstruction in quadricuspid dysfunctional valves yielded the best result over the long term. Dysfunctional aortic roots are something we are faced with more and more in the setting of congenital heart surgery; for example, dysfunctional truncal roots truncus arteriosus, dilated neoaortic root in arterial switch operations, and dilated aortic roots in conotruncal abnormalities.
