Key result
3D CT defines normal aortic valve dimensions, including a ~0.69 geometric height-to-annulus ratio, guiding repair.
Why the study?
Normal dimensions and the relationship between the aortic root and leaflets in the Chinese population needed assessment to establish a matching reference for aortic valve repair.
Observational (n=183)
No
3D computed tomography establishes normal reference dimensions and ratios for the aortic root and leaflets in a Chinese population, providing objective guidance for aortic valve repair.
Provides 3D CT reference values for aortic valve repair planning; leaves open generalizability and prospective outcome validation.
Objective: By assessing the normal dimensions and the relationship between the aortic root and leaflets in Chinese population, the objective of this three-dimensional computed tomography (3DCT)-based study was to establish a matching reference for leaflets and aortic root for aortic valve (AV) repair. Method: Electrocardiogram-gated multi-detector CT was performed on 168 Chinese participants with a normal aortic valve. Measurements of the aortic annuli and leaflets were obtained. The correlations between and the ratios of the specific root and leaflet measurements were analyzed. The references for the leaflet and root dimensions were suggested based on geometric height (gH) using a linear regression equation. The utility of the ratios was tested with CT images of 15 patients who underwent aortic valve repair. Result: The mean annulus diameter (AD), sino-tubular junction (STJ) diameter, geometric height (gH), effective height (eH), free margin length (FML), commissural height (ComH), inter-commissural distance (ICD), and coaptation height (CH) were 22.4 ± 1.7 mm, 27.3 ± 2, 0.4 mm, 15.5 ± 1.7 mm, 8.9 ± 1.2 mm, 32.0 ± 3.4 mm, 17.9 ± 1.9 mm, 23.1 ± 2.3 mm, and 3.1 ± 0.6 mm, respectively. The gH/AD, FML/ICD, and eH/ComH ratios were 0.69 ± 0.07, 1.38 ± 0.08, and 0.50 ± 0.07, respectively. The gH correlated with all other leaflet and root measurements ( P < 0.01), whereas the FML demonstrated a better correlation with ICD compared with gH (R 2 = 0.75, and R 2 = 0.37, respectively). The FML/ICD and eH/ComH ratios might be used to assess leaflet-root mismatch and post-repair leaflet billowing. Conclusion: The normal aortic valve measurements based on 3DCT revealed a specific relationship between the root and leaflets; and this will guide the development of an objective method of aortic valve repair.
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Yang et al. (2021) conducted an observational in Normal aortic valve and aortic regurgitation (n=183). 3D computed tomography (3DCT) was evaluated on Normal dimensions and relationship between aortic root and leaflets (e.g., gH/AD ratio). Three-dimensional computed tomography established normal aortic valve measurements and specific leaflet-root relationships, including a mean geometric height to annulus diameter ratio of 0.69, to guide aortic valve repair.
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