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Aortic valve fenestrations: Macroscopic assessment and functional anatomy study.
Damian Dudkiewicz1, Jorge D Zhingre Sanchez2, Jakub Hołda1
1HEART - Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland.
Clinical Anatomy (New York, N.Y.)
|January 4, 2023
Summary
Aortic valve fenestrations, or tissue loss in the aortic valve leaflets, are common and increase in size with age. These findings, observed in 43% of hearts, impact valve function and dimensions.
Area of Science:
- Cardiovascular Anatomy
- Pathology
- Biomechanical Analysis
Background:
- Aortic valve fenestrations are characterized by loss of leaflet tissue.
- Their clinical significance and functional anatomy remain unclear.
- This study investigates the prevalence and characteristics of these fenestrations.
Purpose of the Study:
- To investigate the varied functional anatomies of aortic valve fenestrations.
- To determine the prevalence and location of aortic valve fenestrations.
- To assess the impact of fenestrations on aortic valve dimensions and leaflet behavior.
Main Methods:
- Macroscopic assessment of 400 autopsied human hearts.
- Imaging of 16 reanimated human hearts using Visible Heart® methodologies.
- Analysis of fenestration prevalence, location, size, and correlation with donor age.
Main Results:
- Aortic valve leaflet fenestrations were found in 43.0% of hearts.
- Fenestrations were most common in the left leaflet and located at the free edge in commissural areas.
- Hearts with fenestrations showed larger aortic valve diameters and areas, with size increasing with donor age.
Conclusions:
- Aortic valve fenestrations are a frequent finding with potentially significant implications.
- Fenestration size increases with age, and they exhibit altered leaflet behavior.
- These findings highlight the importance of considering fenestrations in cardiovascular assessments.
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