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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

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The aortic root, do we see the 'hole' picture?

Georgios Belitsis^1,2, Jonathan Robert Finch³

¹Department of Children's Cardiovascular Disease, Institute of Cardiovascular Science, University College London, London, UK.

Indian Journal of Thoracic and Cardiovascular Surgery

|August 19, 2024

Summary

The aortic root

Keywords:

Aortic root Coronary development Heart development Left ostial process Valve sparing

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Area of Science:

Anatomy
Cardiology
Evolutionary Biology

Background:

The aortic root is traditionally viewed as a simple tube, with focus on its internal structures like coronary ostia.
The external myocardial component, termed the 'left ostial process,' is often overlooked in anatomical and clinical contexts.

Purpose of the Study:

To challenge the oversimplified view of the aortic root.
To highlight the significance of the 'left ostial process' and advocate for its recognition and investigation.

Main Methods:

Conceptual review and anatomical analysis.
Literature synthesis on aortic root and related myocardial structures.

Main Results:

The 'left ostial process,' a myocardial mass continuous with the aortic root, has been historically neglected.
This structure's continuity suggests potential unique physiological roles.

Conclusions:

The 'left ostial process' may play a critical role in cardiac embryology, including coronary artery dominance.
Greater recognition and research into this structure are warranted due to its potential evolutionary significance.