Aortic valve cusp size and shape in dilated trileaflet aortic roots.

Area of Science:

• Cardiovascular imaging and anatomy
• Aortic root morphology
• Valvular heart disease

Background:

• Trileaflet aortic roots can dilate, potentially leading to aortic regurgitation.
• Understanding cusp and root dimensions is crucial for diagnosing and managing aortic root abnormalities.

Purpose of the Study:

• To quantify differences in cusp size and shape between normal and dilated trileaflet aortic roots.
• To compare dilated roots with and without aortic regurgitation.

Main Methods:

• Retrospective analysis of computed tomography (CT) scans.
• Measurement of aortic root and cusp dimensions, normalized to assess shape.
• Comparison between normal roots, dilated roots, and dilated roots with varying degrees of aortic regurgitation.

Main Results:

• Dilated aortic roots showed increased dimensions and a higher commissural to basal ring diameter ratio.
• Cusps in dilated roots were larger, elongated, with increased normalized cusp insertion and free margin lengths.
• Moderate to severe aortic regurgitation in dilated roots correlated with larger commissural diameter but not altered cusp dimensions.

Conclusions:

• Cusp elongation in dilated aortic roots is primarily transverse.
• Functional aortic regurgitation is attributed to extensive commissural dilation, not inadequate cusp adaptation.