J. Scott Rankin, MD, M. Crockett Bone, BS, Peter M

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Presentation transcript:

A refined hemispheric model of normal human aortic valve and root geometry J. Scott Rankin, MD, M. Crockett Bone, BS, Peter M. Fries, MD, Diana Aicher, MD, Hans-Joachim Schäfers, MD, Philip S. Crooke, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 146, Issue 1, Pages 103-108.e1 (July 2013) DOI: 10.1016/j.jtcvs.2012.06.043 Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Representative transverse computed tomographic angiographic (CTA) slices of an aortic valve at 4 mm intervals along the axis of the valve. Using Mathematica software (Wolfram Research, Inc, Champaign, Ill), individual colored points were placed in high-density to define specific aortic root structures for regression analyses. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 103-108.e1DOI: (10.1016/j.jtcvs.2012.06.043) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Aortic valve geometry. A, Representative computed tomographic angiography of a normal valve with coordinates placed. B, Average dimensions of valves analyzed in this study; green ellipse is valve base, black points are commissures, purple circle is the right coronary leaflet-sinus complex, and blue dots are the centrums of the various leaflet sinus complexes. C, Green ellipse is the elliptical valve base; blue vertical lines are the centrums of the leaflet–sinus complexes; red is the leaflet aortic junction, or the valve annulus. D, Model of a reconstructed valve; orange structure represents the right coronary leaflet–sinus complex and the brown is the elliptical valve base. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 103-108.e1DOI: (10.1016/j.jtcvs.2012.06.043) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Leaflet geometry. A, computed tomographic angiographic frame from which the geometry is derived. B, View of the reconstructed valve from below showing leaflet geometry. C, An infinite number of transverse lines were placed on the leaflet. D, leaflet geometry after the lines are placed on a flat surface. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 103-108.e1DOI: (10.1016/j.jtcvs.2012.06.043) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Leaflet coaptation. A, computed tomographic angiographic frame from which the geometry is derived. B, View of the reconstructed valve from below showing leaflet geometry. C, A different perspective of the intersecting leaflets. D, A set of transverse lines was calculated from the curve that is formed from the intersection of 2 leaflets. In all of the Figures, the parts of the leaflets beyond the plane of coaptation were predicted by the regression analyses and are purely mathematical. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 103-108.e1DOI: (10.1016/j.jtcvs.2012.06.043) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Orientation of transverse 1 mm computed tomographic angiographic (CTA) slices out the longitudinal axis of the aortic valve and root. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 103-108.e1DOI: (10.1016/j.jtcvs.2012.06.043) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 A representative valve reconstructed with ellipsoid models. The green leaflet–sinus complex is the right cororay, the yellow is the noncoronary, and the purple is the left coronary. The left ventricular outflow tract is shown in red. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 103-108.e1DOI: (10.1016/j.jtcvs.2012.06.043) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions