Study of Aortic Root Geometry-Anatomical Assessment

Maharathi, P (2020) Study of Aortic Root Geometry-Anatomical Assessment. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: The heart is described as a fused pair of muscular pumps with valves. It circulates blood in series through left (systemic) and right (pulmonary) circulations. The conduction tissues and fibromuscular framework of these separate pumps are interwoven structurally. The heart has four chambers, the two atria that receives venous blood and act as weakly contractile reservoirs in filling the two ventricles. The two ventricles forces the blood into the main arterial trunks by means of powerful expulsive contraction. Among the two ventricles, the left ventricle has inlet and outlet regions guarded by valves. The inlet region is guarded by mitral valve and the outlet region is guarded by aortic valve (ostium arteriosum) Aortic valve is located between left ventricle and aorta. Through the aortic orifice, blood is expelled from the apex of the heart. Among the four cardiac valves the aortic and pulmonary valves are semilunar valves having cusps that are semilunar in shape. AIM OF THE STUDY: To study and assess the anatomical characteristics of aortic root. METHODS: This study analyzed 100 healthy hearts. By dissection method 50 hearts were analyzed and by echocardiographic method 50 hearts were analyzed. The parameters assessed in dissection method were height of the cusp, length and width of the lunule, intercommissural distance and position of coronary Ostia. The parameters assessed in echocardiographic method were aortic sinus diameter, annulus diameter and sinutubular junction diameter. RESULTS: All the hearts assessed were reported to have tricuspid aortic valve. The height of the cusp,the width and length of the lunule in left coronary cusp was found to be larger than in the right and non -coronary cusp. The mean height of the cusp was 14.47mm.The mean width and length of the lunule were 3.86mm and 29.08mm respectively. The mean external intercommissural distance was 23.88mm which was observed to be larger than the internal intercommissural distance in all the cusps whose mean value is 20.34mm. The coronary ostia was positioned almost at the centre of the distance between the two adjacent commissures in both right and left coronary cusps. The mean distance of the position of ostia from the nadir of sinus in right and left coronary cusps are 14.02mm and 13.26mm respectively. Regarding the echocardiographic parameters, the mean aortic sinus diameter was 31.02mm, mean annulus diameter was 22.35mm and mean sinutubular junction diameter was 25.15mm.The diameter of aortic sinus was found to be the largest diameter and that of the annulus was found to be the smallest diameter. CONCLUSION: The anatomical assessment of aortic root is essential in planning the treatment strategies in cardiothoracic surgeries. Thus the knowledge of anatomy of aortic root will be helpful for cardiothoracic surgeons in performing aortic valve repair and replacement using mechanical or biological valve thereby reducing morbidity and mortality in patients with aortic valve disease.

Item Type: Thesis (Masters)
Additional Information: 201733051
Uncontrolled Keywords: Heart, Aortic root, cusps, intercommissural distance, coronary ostia.
Subjects: MEDICAL > Anatomy
Depositing User: Subramani R
Date Deposited: 06 Feb 2021 03:08
Last Modified: 06 Feb 2021 03:08

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