Aortic root morphology: a paradigm for successful reconstruction.

Details

Serval ID
serval:BIB_12AB2E6A1F69
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Aortic root morphology: a paradigm for successful reconstruction.
Journal
Interactive cardiovascular and thoracic surgery
Author(s)
Berdajs D.A.
ISSN
1569-9285 (Electronic)
ISSN-L
1569-9285
Publication state
Published
Issued date
01/2016
Peer-reviewed
Oui
Volume
22
Number
1
Pages
85-91
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
Aortic root (AoR) components provide synchronous and precise 3D deformation of the aortic root during the cardiac cycle in order to ensure closure and opening of the three leaflets over a lifetime. Any deviation from the natural 3D morphology, such as with AoR annulus dilatation, enlarged sinuses and/or dilatation of the sinotubular junction, as in the case of ascending aortic dilatation, may result in disruption of the natural AoR function. Surgical treatment of AoR pathology has two modalities: the replacement of the aortic valve by artificial prosthesis or by preservation of the three leaflets and reconstruction of the aortic root components. Currently, there are two basic aortic root reconstruction procedures: aortic root sparing and aortic valve reimplantation techniques. Regardless of the technique used, the restoration of adequate cusp coaptation, is from a technical point of view, the most important element to consider. To achieve this, there are two requirements that need to be met: (i) the valve coaptation should be superior to the level of the aortic root base by at least 8 mm and (ii) the coaptation height per se has to be ≥5 mm. Successful restoration of the aortic root requires adequate technical skills, detailed knowledge of aortic root anatomy and topography, and also knowledge of the spatial pattern of AoR elements. Recently, there has been growing interest in aortic root reconstructive procedures as well their modifications. As such, the aim of this review is to analyse aortic root topography and 3D anatomy from a surgical point of view. The review also focuses on potential risk regions that one should be aware of before the surgical journey into the 'deep waters area' of the AoR begins.

Keywords
Aorta, Thoracic/anatomy & histology, Aortic Valve/anatomy & histology, Heart Valve Diseases/diagnosis, Heart Valve Diseases/surgery, Heart Valve Prosthesis Implantation/methods, Humans, Imaging, Three-Dimensional, Reconstructive Surgical Procedures/methods, Vascular Surgical Procedures/methods, Aortic root, Surgical anatomy, Valve reconstruction
Pubmed
Web of science
Open Access
Yes
Create date
19/02/2016 20:09
Last modification date
20/08/2019 12:40
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