aortic rootsurgical anatomy

dicky a wartono ,mdStaff surgeon & aortic consultant

national cardiovascular centre harapan kitaJakarta 2014

Surgical Anatomy of the Heart’, Cambridge University Press, Dr Benson Wilcox and Andrew Cook

MMCTS 2007 (0102): : 02527doi: 10.1510/mmcts.2006.002527

Heart 2000;84:670-673 doi:10.1136/heart.84.6.670

aortic root• Surgeons operating on the aortic root• The essence of the valvar complex is the

semilunar attachments of the valvar leaflets. – extend from their basal attachments within the left

ventricle to their distal attachments at the sinutubular junction

• The extent of the leaflets defines the length of the root. – Within this length, the semilunar lines of attachments

of the leaflets cross the anatomic ventriculo-aortic junction (circular line marking the transition from ventricular to arterial walls)

aortic root• outflow tract from the left ventricle, – provides the supporting structures for the leaflets of

the aortic valve, • surrounding and supporting the leaflets, – extends from the basal attachments of the leaflets

within the left ventricle to the sinutubular junction• its walls being made up of the aortic valvar

sinuses – along with the interdigitating intersinusal fibrous

triangles, and with two small crescents of ventricular muscle incorporated at its proximal end

Clinical implications

• The root is much wider at the midpoint of the sinuses than at either the sinutubular junction or at the basal attachment of the leaflets, whilst the basal diameter can be up to one-fifth wider than the outlet at the sinutubular junction

• Proper values can only be provided when measurements are made at the bottom of the valvar attachments, at the widest point of the sinuses, and also at the sinutubular junction

Thank You