Integrated morphologic and functional assessment of the aortic root after different tissue valve root replacement procedures  Ryo Torii, PhD, Ismail El-Hamamsy,

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Integrated morphologic and functional assessment of the aortic root after different tissue valve root replacement procedures  Ryo Torii, PhD, Ismail El-Hamamsy, MD, PhD, Mohamed Donya, MD, Sonya V. Babu-Narayan, MB BS, BSc, PhD, MRCP, Michael Ibrahim, MD, Philip J. Kilner, MD, PhD, Raad H. Mohiaddin, MD, PhD, FRCR, FRCP, FESC, Xiao Yun Xu, PhD, Magdi H. Yacoub, MD, DSc, FRCS, FRCP, FRS  The Journal of Thoracic and Cardiovascular Surgery  Volume 143, Issue 6, Pages 1422-1428.e2 (June 2012) DOI: 10.1016/j.jtcvs.2011.12.034 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Statistical comparisons of key morphologic and hemodynamic parameters: comparisons of sinus diameter, effective orifice area ratio, stroke volume, maximum velocity, and mean shear rate among the subject groups (values mean ± SD). Asterisk indicates P < .05 versus control; double asterisk indicates P < .01 versus control; triple asterisk indicates P < .001 versus control. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1422-1428.e2DOI: (10.1016/j.jtcvs.2011.12.034) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Volumetric flow rate waveforms. Mean reconstructed temporal volumetric flow rate profiles (waveforms) for 4 subject groups (SD at peak flow for each group, 149, 123, 98.1, and 53.7 mL/s, respectively). The individual profiles were first normalized to heart rate and averaged over the subject group, and then the mean RR interval for each group was assigned to the averaged profile. B, Spatiotemporal velocity maps. Representative spatiotemporal velocity maps for 4 groups. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1422-1428.e2DOI: (10.1016/j.jtcvs.2011.12.034) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Effective orifice area. Velocity maps (color contours) and effective orifice areas (broken lines) visualized on cross sections above the valves at peak flow for all 4 subject groups. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1422-1428.e2DOI: (10.1016/j.jtcvs.2011.12.034) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Selected frames from cine steady-state free precession images. Images acquired from an autograft patient at beginning of systole (top) and peak flow (bottom); a cross-sectional view of the aortic sinus at the valve (left) and a long-axis view of the left ventricular outflow tract (right). The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1422-1428.e2DOI: (10.1016/j.jtcvs.2011.12.034) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Typical image analysis result for a patient with an autograft. Original magnitude and phase magnetic resonance images, reconstructed velocity profile in 3-dimensional representation, and shear rate map (from left to right in the top row) at peak (A) and at middiastole (B). The bottom row shows the reconstructed flow waveform and the calculated effective orifice area. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 1422-1428.e2DOI: (10.1016/j.jtcvs.2011.12.034) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions