The aortic root: structure, function, and surgical reconstruction

• Published in: Heart Vol. 83; no. 4; pp. 376 - 380
• Main Authors: Underwood, M J, El Khoury, G, Deronck, D, Glineur, D, Dion, R
• Format: Journal Article Book Review
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.04.2000; BMJ; BMJ Publishing Group LTD
• Subjects: Anatomy & physiology; Aortic Valve - anatomy & histology; Aortic Valve - physiology; Aortic Valve - surgery; Aortic Valve Insufficiency - physiopathology; Aortic Valve Insufficiency - surgery; Biological and medical sciences; Coronary vessels; Doppler effect; Humans; Long term; Marfan syndrome; Medical sciences; Pathology; Prostheses; Review; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgical techniques; Suture Techniques; Three dimensional imaging; Thromboembolism; Human; Pathophysiology; Root; Conservation; Cardiovascular disease; Anatomy; Aortic regurgitation; Biological activity; Treatment; Cardiac valvular disease; Surgery; Aorta; Technique; Aortic valve
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heart.83.4.376

The term "annulus" is frequently used to describe the area of collagenous condensation at the point of leaflet attachment, particularly in surgical literature, but it should be recognised that this term implies a circular structure and as such is inaccurate. 7 The posterior aspect of the aortic root (mainly non-coronary leaflet) is supported by fibrous tissue for approximately 55% of its circumference (membranous part of the septum to the left fibrous trigone), 7 while the remainder is supported by ventricular muscle, an important distinction when performing a surgical annuloplasty as will be discussed later. In the longer term, however, concerns still exist with respect to the potential for late deterioration in valve function and continued follow up is required. 23 In the remodelling operation, although attention is given to creating neo-sinuses, particularly using the technique described by Verrier and colleagues, the operation is carried out using a non-compliant tube (Dacron) which in the long term may have a detrimental effect on the function of the aortic valve because of leaflet damage.