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The differences between bisecting and off‐center cuts of the aortic root: The three‐dimensional anatomy of the aortic root reconstructed from the living heart
Author(s) -
Mori Shumpei,
Anderson Robert H.,
Tahara Natsuko,
Izawa Yu,
Toba Takayoshi,
Fujiwara Sei,
Shimoyama Shinsuke,
Watanabe Yoshiaki,
Nishii Tatsuya,
Kono Atsushi K.,
Takahashi Satoru,
Hirata Kenichi
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13468
Subject(s) - aortic root , basal (medicine) , cardiac skeleton , medicine , anatomy , aortic valve , aorta , cardiology , nuclear medicine , insulin
Background It is axiomatic that the diameter of the virtual basal ring of the aortic root, which is elliptical rather than circular, will differ when assessed using between bisecting as opposed to off‐center cuts. Such differences, however, which pertain directly to echocardiographic assessments of the so‐called valvar annulus, have yet to be systematically explored. Methods We retrospectively analyzed 30 patients undergoing coronary computed tomographic angiography, measuring the virtual basal ring diameter using routine multiplanar reconstructions. We made orthogonal bisecting cuts from the nadir of the hinge of the right coronary aortic leaflet to the center of the opposite inter‐leaflet fibrous triangle between the noncoronary and left coronary aortic leaflets. We compared these measurements with orthogonal off‐center cuts made through the nadirs of the hinges of the adjacent leaflets. Results The measured diameter of the virtual basal ring was significantly longer when measured using the bisecting cut as opposed to all off‐center cuts (mean difference: 1.35±1.34 mm, P <.0001; 0.77±0.95 mm, P =.0001, respectively). The measured diameters of the sinuses of Valsalva, in contrast, were significantly shorter when measured using the bisecting cut (mean difference: −3.24±1.38 mm, P <.0001; −2.86±1.61 mm, P <.0001). Conclusions There are significant differences in the diameters of the aortic root, which represent the echocardiographic annulus, when measured using bisecting as opposed to off‐center cuts. Account should be taken of these differences when using cross‐sectional echocardiographic measurements to assess the dimensions of the aortic root.