title: Aortic root geometry: pattern of differences between leaflets and sinuses of Valsalva.
abstract: OBJECTIVE
  Growing interest in aortic root replacement with the use of stentless auto-, homo- and xenografts, and new developments in aortic valve conservation demand a deeper understanding of the normal aortic root anatomy.
  
  
  METHODS
  Ten cryopreserved human aortic roots were pressurized, fixed and measured directly (leaflet free edge and attachment) and using three-dimensional computed tomography imaging software (sinus of Valsalva height and volume).
  
  
  RESULTS
  The mean of the measurements of all four parameters yielded a pattern in which the non-coronary sinus (N) structures had the greatest dimensions followed by the right (R) and then the left (L). Non-parametric ANOVA on each of these parameters also showed significant differences among the sinuses yielding a pattern of N > R > L. This pattern determined an angle of tilt between the plane at the base (annulus) and the plane intersecting the sinotubular junction with a mean value of 11 degrees. Linear regression indicated that this angle did not depend on the size of the base (annulus).
  
  
  CONCLUSIONS
  The data showed a geometric pattern of the aortic root, with the structures of the non-coronary sinus being the largest followed by the right and then the left. The possible hemodynamic relevance and surgical implications of these findings need to be explored.
authors.affiliation: International Heart Institute of Montana Foundation, St. Patrick Hospital, Missoula, Montana 59802, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Choo
authors.forename: G
authors.initials: G
authors.lastname: McRae
authors.forename: J P
authors.initials: JP
authors.lastname: Olomon
authors.forename: G
authors.initials: G
authors.lastname: St George
authors.forename: W
authors.initials: W
authors.lastname: Davis
authors.forename: C L
authors.initials: CL
authors.lastname: Burleson-Bowles
authors.forename: D
authors.initials: D
authors.lastname: Pang
authors.forename: H H
authors.initials: HH
authors.lastname: Luo
authors.forename: D
authors.initials: D
authors.lastname: Vavra
authors.forename: D T
authors.initials: DT
authors.lastname: Cheung
authors.forename: J H
authors.initials: JH
authors.lastname: Oury
authors.forename: C M
authors.initials: CM
authors.lastname: Duran
mesh_terms: D001021:Aortic Valve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D015925:Cryopreservation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D012850:Sinus of Valsalva / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods