Asymmetric Dynamics of the Native Aortic Annulus Evaluated by Force Transducer and Sonomicrometry in a Porcine Model

Figures

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  Figure. 1. (a) Position of force transducer at the aortic annulus with three arms at each interleaflet triangle at annular level. Arrows indicate direction of force measurement during expansion. (b) Position of six sonomicrometry crystals at the aortic annulus. Reference crystals in the ascending aorta and apex of the left ventricle are not displayed. A Sinotubular junction, B sinuses of valsalva, C aortic annulus, D sonomicrometry crystal.

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  Figure. 2. Relationship between force at the three interleaflet triangles of the aortic annulus (LN, RN, LR) and aortic pressure from one representative pig throughout two cardiac cycles. The force measurements offsets were zeroed in mid-diastole. AP Aortic pressure, MS mid-systole, MD mid-diastole, LN left/non-coronary interleaflet triangle, RN right/non-coronary interleaflet triangle, LR left/right interleaflet triangle.

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  Figure. 3. Maximum–Minimum radial force for each of the three interleaflet triangles of the aortic annulus (LN, RN, LR). LN Left/non-coronary interleaflet triangle, RN right/non-coronary interleaflet triangle, LR left/right interleaflet triangle. Mean + SD. *p < 0.05 between all three segments.

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  Figure. 4. Aortic annulus area (AAA) (left) and aortic annulus circumference (AAC) (right) presented at four defined time points throughout the cardiac cycle (ED, MS, ES, MD). ED End-diastole, MS mid-systole, ES end-systole, MD mid-diastole. Mean + SD.

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  Figure. 5. Annular segmental expansion from Mid-diastole to Mid-systole (MS-MD) illustrated with a scaled color legend. Red indicates a large expansion and blue indicates no expansion. NC Non-coronary sinus, LC left coronary sinus, RC right coronary sinus.

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  Figure. 6. Cross-sectional diameters NC–LR (crystal 1–4), RC–LN (crystal 2–5) and LC–RN (crystal 3–6) presented at four defined time points throughout the cardiac cycle. ED End-diastole, MS mid-systole, ES end-systole, MD mid-diastole, NC non-coronary sinus, LR left/right interleaflet triangle, RC right coronary sinus, LN left/non-coronary interleaflet triangle, LC left coronary sinus, RN right/non-coronary interleaflet triangle. Mean + SD.