[Does dilatation of the sinotubular junction cause aortic regurgitation?: the use of the experimental model and preliminary result].
This study investigated the mechanism of aortic regurgitation caused by dilatation of the sinotubular junction. The canine model of dilatation of the sinotubular junction was used to observe coaptation of the aortic valve using direct imaging by endoscopy. Five adult mongrel dogs (body weight: 20-25 kg) were anesthetized and their hearts and thoracic aortas were extracted en bloc. Aortotomy was performed and an interrupted horizontal mattress suture was placed in each commissure and each sinus of Valsalva at the level of the sinotubular junction. The heart and thoracic aorta were fixed on a table and the interrupted sutures were drawn horizontally. As a result, the aorta of the junction level was dilated. Strain of the interrupted sutures were changed by weights of 20, 25, 50, 70 and 100 points (1 point = 3.5 g). The sites of the retracted sutures were the three commissures and three sinuses of Valsalva. With increased strain of the sutures, the opening of the aortic valve was exaggerated when drawing was done on either all sutures or the commissures. When drawing was done only on the three sinuses of Valsalva, coaptation of the aortic valve was uninterrupted. This study showed that dilatation of the sinotubular junction causes aortic regurgitation, which is mainly due to the outward deviation of the commissures.
Department of Cardiovascular Surgery, Saga Prefectural Hospital.
K
K
Furukawa
H
H
Ohteki
K
K
Doi
H
H
Ohnishi
Y
Y
Narita
Z L
ZL
Cao
T
T
Itoh
D000818:Animals; D001011:Aorta / Q000473:pathology*; D001022:Aortic Valve Insufficiency / Q000209:etiology*; D004108:Dilatation, Pathologic; D004195:Disease Models, Animal; D004285:Dogs; D012850:Sinus of Valsalva / Q000473:pathology*