Relationship Between Leaflets and Root in Normal Aortic Valve Based on Computed Tomography Imaging: Implication for...

Area of Science:

• Cardiovascular Imaging
• Anatomical Studies
• Surgical Planning

Background:

• Accurate aortic valve repair requires precise understanding of aortic root and leaflet dimensions.
• Existing references may not fully capture population-specific anatomical variations.
• Three-dimensional computed tomography (3DCT) offers detailed visualization for anatomical assessment.

Purpose of the Study:

• To establish normal aortic root and leaflet dimensions in the Chinese population using 3DCT.
• To define relationships between aortic root and leaflet measurements for aortic valve (AV) repair.
• To develop an objective reference for leaflet-root matching in AV repair.

Main Methods:

• 168 Chinese participants with normal aortic valves underwent electrocardiogram-gated multi-detector CT.
• Measurements of aortic annuli and leaflets were obtained.
• Correlations and ratios between dimensions were analyzed, with references suggested based on geometric height (gH).

Main Results:

• Normal mean dimensions for annulus diameter (AD), sino-tubular junction (STJ) diameter, gH, effective height (eH), free margin length (FML), commissural height (ComH), inter-commissural distance (ICD), and coaptation height (CH) were determined.
• Key ratios like gH/AD, FML/ICD, and eH/ComH were calculated.
• FML showed a stronger correlation with ICD (R² = 0.75) than gH (R² = 0.37), suggesting utility in assessing leaflet-root mismatch.

Conclusions:

• 3DCT-based measurements reveal specific relationships between aortic root and leaflets in the Chinese population.
• Ratios such as FML/ICD and eH/ComH can aid in assessing leaflet-root mismatch and post-repair leaflet billowing.
• This study provides an objective reference to guide aortic valve repair procedures.