After replacement of a bicuspid aortic valve with a Freestyle stentless xen
ograft, right coronary leaflet dysfunction and an elevated pressure gradien
t developed. Attempts to match the right and left ostia of the prosthesis,
which were located at an angle of less than 120 degrees, to the native righ
t and left ostia, which were located at 180 degrees, may have resulted in t
he leaflet distension. This is a suggestive finding about its implantation
technique. (C) 1999 by The Society of Thoracic Surgeons.