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Study Explores Size Ratio in Aortic Valve Leaflets and Root Using CT Imaging

This is a summary of the study conducted by Tianyang Yang, Haini Wen, Ismail El-Hamamsy, Qiming Ni, Yanbin Sun, and Dan Zhu available to read here entitled “Relationship Between Leaflets and Root in Normal Aortic Valve Based on Computed Tomography Imaging: Implication for Aortic Valve Repair” published in Frontiers in Cardiovascular Medicine in November 2021. This study explores the use of computed tomography (CT) imaging to measure the relationship between root and leaflet measurements and applying these findings in patients undergoing aortic valve (AV) repair.

This is a summary of the study conducted by Tianyang Yang, Haini Wen, Ismail El-Hamamsy, Qiming Ni, Yanbin Sun, and Dan Zhu available to read here entitled “Relationship Between Leaflets and Root in Normal Aortic Valve Based on Computed Tomography Imaging: Implication for Aortic Valve Repair” published in Frontiers in Cardiovascular Medicine in November 2021. This study explores the use of computed tomography (CT) imaging to measure the relationship between root and leaflet measurements and applying these findings in patients undergoing aortic valve (AV) repair.

When a patient’s aortic valve (AV) is in need of repair, it may be due to aortic root aneurysm or aortic regurgitation (AR). These conditions often require surgical repair, though surgical repair for the aortic valve presents unique challenges. In an effort to further understand the ways in which aortic root and leaflet size interact and can influence AV repair outcomes, Yang et al. enrolled 168 healthy participants into their study which used CT imaging to measure both leaflets and aortic roots. They then used linear regression to develop the ratio between these structures. This was in an effort to further understand the size relationship between these parts of the AV and how their size may be impacted pre- and post-AV repair in patients with aortic regurgitation (AR) and aortic root aneurysm.

Measurements taken from 168 participants were used to develop a ratio between the different anatomical structures within an AV which begins to set the standard for a baseline ratio. The researchers then retroactively analyzed the measurements of the 15 patients who did undergo AV repair. This comparison allowed for the exploration in what it may mean to use these measurements for future patients, as the study found the ratios would be useful in pre-operative AR assessment or post-operative review (pg. 10).

This study is unique in that it aimed to explore these measurements in patients while living, as opposed to the ex vivo nature of similar studies. This pursuit was made possible through the use of three dimensional computed tomography (3DCT). The in vivo nature of this study allowed for measurements to be taken while blood flow was active, which is useful when one considers how these findings can be applied in patients undergoing surgery. It allows for a more accurate overview as well as different pressure levels to be taken into account.

The study was able to begin to form a baseline related to the measurements that may be applicable to future patients undergoing AV repair. More research may lead to more effective methods for restoring AV roots in patients undergoing surgical repair. Further study with an increased amount of participants whose measurements are able to be taken is needed, but this is a starting point for future consideration of these measurements and their applicability in patients undergoing repairs.

For additional information about how the study was conducted, how data was analyzed, and specific numeric study findings, please refer to the original publication referenced below.

Reference:

Yang T, Wen H, El-Hamamsy I, Ni Q, Sun Y, Zhu D. Relationship Between Leaflets and Root in Normal Aortic Valve Based on Computed Tomography Imaging: Implication for Aortic Valve Repair. Front Cardiovasc Med. 2021 Nov 22;8:731440. doi: 10.3389/fcvm.2021.731440. PMID: 34881298; PMCID: PMC8645849.

 

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