| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1991;52:640-646
© 1991 The Society of Thoracic Surgeons
a Department of Paediatrics, National Heart and Lung Institute, London, United Kingdom
b Department of Pathology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
c Department of Surgery, Institute of Child Health, University of Liverpool, Liverpool, United Kingdom
* Address reprint requests to Prof Anderson, Department of Paediatrics, National Heart and Lung Institute, Dovehouse St, London SW3 6LY, United Kingdom.
Surgical repair of the small aortic root is limited in part by the very structure of the outflow tract from the left ventricle. The root is not constructed on the basis of a ringlike annulus supporting the leaflets of the aortic valve. The only truly circular structure within the outflow tract is the junction of the aortic wall with the underlying ventricular structures, themselves partly muscular and partly fibrous. This circular ventriculoarterial junction is crossed by the semilunar attachments of the leaflets of the aortic valve, producing an interlinking arrangement between the expanded aortic sinuses and three triangles of fibrous tissue placed beneath the apexes of the commissures between the valve leaflets. The triangles form extensions of the left ventricle that are related, in part, to the pericardial cavity surrounding the heart. The arrangements of the attachment of the leaflets in malformed valves with two (or only one) effective leaflets are highly abnormal, although these valves are usually produced on the template of three aortic sinuses. The valve with two leaflets rarely gives problems during childhood. In valves producing "critical stenosis," there is usually only one effective leaflet, a condition due to incomplete liberation of two of the anticipated three commissures. Detailed study shows that, in these malformed hearts, the attachment of the leaflets is much more annular than in normal valves, with inadequate formation of the fibrous triangles.
This article has been cited by other articles:
|
|
 |
|
  H.-H. Sievers, W. Hemmer, F. Beyersdorf, A. Moritz, R. Moosdorf, A. Lichtenberg, M. Misfeld, E. I. Charitos, and on behalf of the Working Group for Aortic Valve Su The everyday used nomenclature of the aortic root components: the tower of Babel? Eur J Cardiothorac Surg, December 1, 2011; (2011) ezr093v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. del Valle-Fernandez, V. Jelnin, G. Panagopoulos, Y. Dudiy, L. Schneider, P. T. de Jaegere, C. Schultz, P. W. Serruys, E. Grube, and C. E. Ruiz A method for standardized computed tomography angiography-based measurement of aortic valvar structures Eur. Heart J., September 1, 2010; 31(17): 2170 - 2178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. P. Caimmi, M. Diterlizzi, E. Grossini, E. I. Kapetanakis, M. Gavinelli, A. Carriero, and G. Vacca Impact of Prosthetic Mitral Rings on Aortomitral Apparatus Function: A Cardiac Magnetic Resonance Imaging Study Ann. Thorac. Surg., September 1, 2009; 88(3): 740 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Piazza, P. de Jaegere, C. Schultz, A. E. Becker, P. W. Serruys, and R. H. Anderson Anatomy of the Aortic Valvar Complex and Its Implications for Transcatheter Implantation of the Aortic Valve Circ Cardiovasc Interv, August 1, 2008; 1(1): 74 - 81. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Lansac, I. Di Centa, F. Raoux, N. A. Attar, C. Acar, T. Joudinaud, and R. Raffoul A lesional classification to standardize surgical management of aortic insufficiency towards valve repair Eur J Cardiothorac Surg, May 1, 2008; 33(5): 872 - 880. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Mihaljevic, M. R. Sayeed, S. C. Stamou, and S. Paul Pathophysiology of Aortic Valve Disease Card. Surg. Adult, January 1, 2008; 3(2008): 825 - 840. [Full Text]
|
|
|
|
 |
|
 M. Misfeld and H.-H. Sievers Heart valve macro- and microstructure Phil Trans R Soc B, August 29, 2007; 362(1484): 1421 - 1436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Lansac, I. Di Centa, F. Raoux, R. Raffoul, N. El Attar, A. Rama, C. Acar, and P. Nataf Aortic annuloplasty: towards a standardized approach of conservative aortic valve surgery MMCTS, January 1, 2007; 2007(0102): mmcts.2006.001958 - mmcts.2006.001958. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Aboulhosn and J. S. Child Left Ventricular Outflow Obstruction: Subaortic Stenosis, Bicuspid Aortic Valve, Supravalvar Aortic Stenosis, and Coarctation of the Aorta Circulation, November 28, 2006; 114(22): 2412 - 2422. [Full Text] [PDF]
|
|
|
|
|
|
E. Lansac Aortic prosthetic ring annuloplasty: a useful adjunct to a standardized aortic valve-sparing procedure? Eur J Cardiothorac Surg, April 1, 2006; 29(4): 537 - 544. [Full Text] [PDF]
|
|
|
|
|
|
R. H. Anderson Further Anatomical Insights Regarding the Ross Procedure Ann. Thorac. Surg., February 1, 2006; 81(2): 411 - 412. [Full Text] [PDF]
|
|
|
|
|
|
T. A. Timek, G. R. Green, F. A. Tibayan, D. T. Lai, F. Rodriguez, D. Liang, G. T. Daughters, N. B. Ingels Jr, and D. C. Miller Aorto-mitral annular dynamics Ann. Thorac. Surg., December 1, 2003; 76(6): 1944 - 1950. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Hopkins Aortic valve leaflet sparing and salvage surgery: evolution of techniques for aortic root reconstruction Eur J Cardiothorac Surg, December 1, 2003; 24(6): 886 - 897. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Mihaljevic, S. Paul, L. H. Cohn, and A. Wechsler Pathophysiology of Aortic Valve Disease Card. Surg. Adult, January 1, 2003; 2(2003): 791 - 810. [Full Text]
|
|
|
|
|
|
E. Lansac, H. S. Lim, Y. Shomura, K. H. Lim, N. T. Rice, W. Goetz, C. Acar, and C. M. G. Duran A four-dimensional study of the aortic root dynamics Eur J Cardiothorac Surg, October 1, 2002; 22(4): 497 - 503. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Lansac, K. H. Lim, Y. Shomura, W. A. Goetz, H. S. Lim, N. T. Rice, H. Saber, and C. M. G. Duran Dynamic balance of the aortomitral junction J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 911 - 918. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M J Underwood, G El Khoury, D Deronck, D Glineur, and R Dion The aortic root: structure, function, and surgical reconstruction Heart, April 1, 2000; 83(4): 376 - 380. [Full Text]
|
|
|
|
|
|
P. Dagum, G. R. Green, F. J. Nistal, G. T. Daughters, T. A. Timek, L. E. Foppiano, A. F. Bolger, N. B. Ingels Jr, and D. C. Miller Deformational Dynamics of the Aortic Root : Modes and Physiologic Determinants Circulation, November 9, 1999; 100(90002): II-54 - II-62. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. M. van Son, R. Battellini, M. Mierzwa, T. Walther, R. Autschbach, and F. W. Mohr AORTIC ROOT RECONSTRUCTION WITH PRESERVATION OF NATIVE AORTIC VALVE AND SINUSES IN AORTIC ROOT DILATATION WITH AORTIC REGURGITATION J. Thorac. Cardiovasc. Surg., June 1, 1999; 117(6): 1151 - 1155. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Delius, M. M. Samyn, and D. M. Behrendt Should a bicuspid aortic valve be replaced in the presence of subvalvar or supravalvar aortic stenosis? Ann. Thorac. Surg., October 1, 1998; 66(4): 1337 - 1342. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Northrup III and V. R. Kshettry Implantation technique of aortic homograft root: emphasis on matching the host root to the graft Ann. Thorac. Surg., July 1, 1998; 66(1): 280 - 284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Anderson The structure of the aortic root J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 870 - 870. [Full Text]
|
|
|
|
|
|
R. H. Anderson Measurement of aortic diameter J. Thorac. Cardiovasc. Surg., July 1, 1997; 114(1): 146 - 146. [Full Text]
|
|
|
|
|
|
R. B. Hokken, M. M. Bartelings, A. J. J. C. Bogers, and A. C. Gittenberger-de Groot MORPHOLOGY OF THE PULMONARY AND AORTIC ROOTS WITH REGARD TO THE PULMONARY AUTOGRAFT PROCEDURE J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 453 - 461. [Abstract] [Full Text]
|
|
|
|
|
|
J. A. M. van Son, V. M. Reddy, M. D. Black, H. Rajasinghe, G. S. Haas, and F. L. Hanley MORPHOLOGIC DETERMINANTS FAVORING SURGICAL AORTIC VALVULOPLASTY VERSUS PULMONARY AUTOGRAFT AORTIC VALVE REPLACEMENT IN CHILDREN J. Thorac. Cardiovasc. Surg., June 1, 1996; 111(6): 1149 - 1157. [Abstract] [Full Text]
|
|
|
|
|
|
J. P. Sutton III, S. Y. Ho, and R. H. Anderson The forgotten interleaflet triangles: A review of the surgical anatomy of the aortic valve Ann. Thorac. Surg., February 1, 1995; 59(2): 419 - 427. [Abstract] [PDF]
|
|
|
|
|
|
J. Caspi, M. N. Ilbawi, D. A. Roberson, W. Piccione Jr., D. O. Monson, and H. Najafi Extended aortic valvuloplasty for recurrent valvular stenosis and regurgitation in children J. Thorac. Cardiovasc. Surg., April 1, 1994; 107(4): 1114 - 1120. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
