Further insights into normal aortic valve function: role of a compliant aortic root on leaflet opening and valve orifice area Vangipuram Canchi Sripathi,

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Presentation transcript:

Further insights into normal aortic valve function: role of a compliant aortic root on leaflet opening and valve orifice area Vangipuram Canchi Sripathi, B.Tech, Ramarathnam Krishna Kumar, PhD, Komarakshi R Balakrishnan, MD The Annals of Thoracic Surgery Volume 77, Issue 3, Pages 844-851 (March 2004) DOI: 10.1016/S0003-4975(03)01518-2

Fig 1 The opening and closing of the aortic leaflets inside a normal root and a stiff root. (a) Opening mode–normal root. (b) Opening mode–stiff root. (c) Opened mode–normal root. (d) Opened position–stiff root. (e) Closing mode–normal root. (f) Closing mode–stiff root. The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)

Fig 2 (a) Displacement diagram of the nodule of Arantius and the commissure point. (b) Pressure–time graph used in this work. The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)

Fig 3 (a) Opening at position “B.” (b) Opening at position “C.” (c) Circular shape of the normal leaflet in a stiff root at position B1. The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)

Fig 4 Relationship between the root area and the systolic pressure. The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)

Fig 5 (a) Variation of effective valve orifice area (EVOA) with pressure (mm Hg) and gradient for a normal valve. (b) Variation of EVOA with pressure (mm Hg) and gradient for a stiff root. The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)

Fig 6 Variation of effective valve orifice area pressure for various gradients (mm Hg) for a normal root. The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)

Fig 7 (a) Leaflet (dark) bending against the root (green) 2 mm gradient. An echocardiogram picture showing the gap between leaflet and the wall. (b) Leaflet (dark) bending against the root (green) 8 mm gradient. The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)

Fig 8 (a) Maximum (Max.) principal stress (S) in the leaflets with normal root during opening. (b) Maximum principal stress in the leaflets with stiff root during opening. (c) Minimum (Min.) principal stress in the leaflets with normal root during opening. (d) Minimum principal stress in the leaflets with stiff root during opening. (Ave. Crit. = nodal averaging criteria; SNEG = surface negative; SPOS = surface positive.) The Annals of Thoracic Surgery 2004 77, 844-851DOI: (10.1016/S0003-4975(03)01518-2)