Three-dimensional Computed Tomographic Analysis of Normal and Aneurysmal Aortic Roots: Is there a True Geometric Pattern in the Aortic Root Anatomy?

Minho Ju, Jae Won Lee, Sang Young Oh, Dong Hyun Yang, Joon-Won Kang, Jun Bum Kim, Song Ho Jung, Chul Hyun Chung, Tae-Hwan Lim, Suk Jung Choo

Asan Medical Center, Seoul, Korea (South)

Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–A

Abstract

Background: Although quantitative information regarding the geometric alteration of the aortic root during aneurysmal expansion may have important implications for surgical repair, they remain limited. To address this issue, the present study compared multiple geometric parameters between normal and aneurysmal aortic roots.

Methods: Between November 2003 and September 2015, the aortic roots of 107 healthy subjects (control group) and 105 annuloaortic ectasia (AAE) patients (AAE group) were analyzed using multiplanar reformatted oblique sagittal computed tomographic images. The inter-commissural distance (ICD), sinus depth(SD), and sinus volume(SV) of the left (LCS), right (RCS), and the non-coronary sinuses (NCS) of Valsalvawere used as the study parameters.

Results: In the control group, all LCS parameters were smaller than in the RCS. They were also generally smaller than the NCS, especially with respect to the SD and SV. However, the ICD only tended to be smaller than in the NCS. In the AAE group, all LCS parameters were significantly smaller than eithertheRCS and NCS parameters,whereas the RCS and NCS were similar.Dimensional enlargement of the LCS was relatively less than either the RCS or NCS in AAE with respect to the corresponding normal sinuses.

Conclusions: The present findings were suggestive of a distinct geometric aortic root pattern characterized by an LCS that was smaller than either the RCS or NCS while the RCS and NCS were similar. In AAE this pattern was preserved and accentuated but the LCS showed lesser enlargement relative to either the RCS or NCS.