Aortic root geometry: pattern of differences between leaflets and sinuses of Valsalva.
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.
Choo
S J
SJ
International Heart Institute of Montana Foundation, St. Patrick Hospital, Missoula, Montana 59802, USA.
McRae
G
G
Olomon
J P
JP
St George
G
G
Davis
W
W
Burleson-Bowles
C L
CL
Pang
D
D
Luo
H H
HH
Vavra
D
D
Cheung
D T
DT
Oury
J H
JH
Duran
C M
CM
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