Commentary: A symmetrical bicuspid aortic valve is not just 180°

Type 0 bicuspid aortic valves (BAVs) according to Sievers classification1 present 2 symmetrical cusps of same size with a perfectly fused cusp, no raphe, and symmetrical anterior and posterior annulus. These valves have shown improved results after repair compared with type 1,2 where there is an incomplete fusion of the conjoined cusps with a raphe and a certain degree of asymmetry between the fused and nonfused cusps. In recent years, we have observed an increased interest in achieving the symmetry during type 1 BAV repair to approach the type 0 configuration and improved results