Surgical anatomy of the aortic annulus: landmarks for external annuloplasty in aortic valve repair

The Annals of Thoracic Surgery
Nizar KhelilEmmanuel Lansac

Abstract

Although reduction of a dilated aortic annulus is becoming an essential parameter for durable valve repair, anatomical descriptions of the annulus and surgical landmarks of the subvalvular plane for an external aortic annuloplasty remain to be defined. Twenty hearts with normal anatomy with tricuspid aortic valves were studied. Annulus diameter, cusp geometric height, and interleaflet triangles heights were measured. The aortic root was dissected externally down to the subvalvular plane as to perform an external aortic annuloplasty or reimplantation procedure proximal anastomosis. Tissue thickness and dissection heights relative to the annulus were measured at each cusp nadir and at the middle of each interleaflet triangle. The mean annulus diameter, cusp geometric height, and interleaflet triangle heights were, respectively, 24.9 ± 0.2 mm, 19.7 ± 0.3 mm, and 20.1 ± 0.5 mm. External dissection of the aortic root reached the subvalvular plane below the nadir of left coronary cusp (-2.7 ± 0.4 mm), noncoronary (NC) cusp (-3.1 ± 0.3 mm), and the base of left-NC interleaflet triangle (-2.1 ± 0.4 mm). External dissection remained above the nadir of the right coronary cusp (+1.4 ± 0.4 mm), base of left-right interleaflet triangle (+2....Continue Reading

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Citations

Nov 27, 2015·General Thoracic and Cardiovascular Surgery·Takashi Kunihara
Jan 19, 2016·The Annals of Thoracic Surgery·Ulrich SchneiderHans-Joachim Schäfers
Jan 3, 2016·The Canadian Journal of Cardiology·Pierre-Emmanuel NolyIsmail El-Hamamsy
Apr 7, 2015·The Annals of Thoracic Surgery·Hans-Joachim Schäfers
Dec 19, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Laurent De KerchoveGebrine El Khoury
Nov 15, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Emmanuel Lansac, Laurent de Kerchove
Mar 3, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Tatsuhiko KomiyaTakehiko Matsuo
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Oct 18, 2016·Current Opinion in Cardiology·Gianluigi Bisleri
Apr 10, 2019·General Thoracic and Cardiovascular Surgery·Minoru MatsuhamaTakashi Kunihara
May 16, 2019·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Bobby YanagawaIsmail El-Hamamsy
Jun 29, 2017·General Thoracic and Cardiovascular Surgery·Takashi Kunihara
Jun 6, 2018·Interactive Cardiovascular and Thoracic Surgery·Mona SharghbinPeter Johansen
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Oct 17, 2020·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Pouya Youssefi, Emmanuel Lansac
Jan 8, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Yu IzawaKen-Ichi Hirata
Aug 26, 2019·The Annals of Thoracic Surgery·Pouya YoussefiEmmanuel Lansac
Jul 23, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hector I MichelenaHans-Joachim Schäfers
Jul 23, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hector I MichelenaUNKNOWN Endorsed by the Heart Valve Society (HVS), European Association of Cardiovascular Imaging (EACVI), Society of Thoracic Surge

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