Surgical anatomy of the aortic root: implication for valve-sparing reimplantation and aortic valve annuloplasty

To enhance the reproducibility of aortic valve-sparing reimplantation and annuloplasty, we analyzed the topographic relationship between the ventriculoaortic junction (VAJ), basal ring (BR), and sinotubular junction (STJ). The root base thickness is also quantified. Fifty-eight fresh human aortic va...

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Vydané v:The Journal of thoracic and cardiovascular surgery Ročník 149; číslo 2; s. 425
Hlavní autori: de Kerchove, Laurent, Jashari, Ramadan, Boodhwani, Munir, Duy, Khanh Tran, Lengelé, Benoit, Gianello, Pierre, Mosala Nezhad, Zahra, Astarci, Parla, Noirhomme, Philippe, El Khoury, Gebrine
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.02.2015
Predmet:
Adult
Aged
Aorta, Thoracic - anatomy & histology
Aorta, Thoracic - surgery
Aortic Valve - anatomy & histology
Aortic Valve - surgery
Aortic Valve Insufficiency - surgery
Cadaver
Cardiac Valve Annuloplasty - methods
Female
Heart Valve Prosthesis Implantation - methods
Humans
Male
Middle Aged
Reproducibility of Results
Tissue Donors
annuloplasty
aortic valve anatomy
aortic insufficiency
valve-sparing surgery
aortic valve repair
ISSN:1097-685X, 1097-685X
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Shrnutí:To enhance the reproducibility of aortic valve-sparing reimplantation and annuloplasty, we analyzed the topographic relationship between the ventriculoaortic junction (VAJ), basal ring (BR), and sinotubular junction (STJ). The root base thickness is also quantified. Fifty-eight fresh human aortic valves were analyzed. The root was dissected to the limit where the aortic wall terminates into the cardiac structures (VAJ). Root height was measured externally from the STJ to the VAJ and internally from the STJ to the BR defined as the plane passing through the cusps nadir. The root base thickness was measured at the BR and orthogonal to the internal wall; except at the right coronary sinus, where it was measured between the BR internally and the VAJ externally. Measurements were taken at the middle of the 3 sinuses and commissures. The VAJ is at the same level as the BR from the noncoronary sinus (-0.1 ± 0.9 mm) to the left coronary sinus (0.5 ± 1.3 mm); it is above the BR from the left/right commissure (4.6 ± 1.4 mm) to the right/non commissure (2.5 ± 1.6 mm). The external root height was highest at the non/left commissure (21.5 ± 2.6 mm) followed by the right/non commissure (19.2 ± 2.3 mm) then the left/right commissure (15.7 ± 2.2 mm) (P < .05). The mean root base thickness was 3.2 mm, ranging from 1 ± 0 mm at the left/non commissure to 6.2 ± 1.2 mm at the right coronary sinus (P < .001). The VAJ is not planar; it is above the level of the BR from the left/right to the right/non commissure. As a consequence, the external height of the non/left commissure is greater than the other 2 commissures. These findings should be taken into consideration when performing aortic valve-sparing reimplantation or external annuloplasty.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:1097-685X
1097-685X
DOI:10.1016/j.jtcvs.2014.09.042