Key result
3D computed tomography analysis of normal subjects showed the left coronary cusp was significantly smaller than the right and non-coronary cusps (P<0.001), with aortic root size increasing with age.
Observational (n=130)
p-value: p=<0.001
In normal subjects, 3D CT analysis reveals significant aortic root asymmetry with a smaller left coronary cusp and age-related increases in root size, which may inform surgical repair techniques and device design.
May inform valve sizing in asymmetric roots; leaves open outcome impact without prospective validation.
AIMS: Understanding normal asymmetry in the aortic root could aid in the development of new surgical repair techniques or devices with improved haemodynamic performance. The purpose of this study was to assess geometric asymmetry and age-related changes in the normal aortic root using 3D computed tomography. METHODS AND RESULTS: The institutional review board approved this retrospective study of 130 normal subjects (mean age, 51.4 years; 58 men). Specialized 3D software measured individual cusp sinus volumes (CSVs), cusp surface areas (CSAs), and intercommissural distances (ICDs). Age-related aortic root changes were evaluated with simple correlation, ANOVA test among age groups, and multivariable linear regression analyses. The CSV and CSA of left coronary cusp (LCC) were significantly smaller than those of right coronary cusp (RCC) and non-coronary cusp (NCC) (both, P < 0.001) in all age groups. The mean ratios of RCC or NCC-to-LCC were 1.38 and 1.36 for CSV, 1.19 and 1.20 for CSA, and 1.21 and 1.06 for ICD, respectively. The CSV and ICD increased in older age with weak-to-moderate correlation coefficients in both men and women. By multivariable linear regression, CSVs and ICDs of all cusps showed a positive correlation with age (P < 0.05), and the female gender was associated with a smaller size of the CSV and CSA. CONCLUSIONS: The LCC was significantly smaller than the other two cusps, and the aortic root size increased with age.
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Yang et al. (2016) conducted an observational in Normal aortic root (n=130). 3D computed tomography was evaluated on Cusp sinus volumes (CSVs), cusp surface areas (CSAs), and intercommissural distances (ICDs) (p=<0.001). 3D computed tomography analysis of normal subjects showed the left coronary cusp was significantly smaller than the right and non-coronary cusps (P<0.001), with aortic root size increasing with age.
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