Anthropo-morphometric patterns of design and proportionality of the aortic valve leaflets in light of reconstructive surgery

Abstract

Background. As long as the design of leaflets is crucial for aortic valve replacement, inaccurate reconstruction can result in failure or stenosis postoperatively.Aim. To analyze average parameters of normal valve leaflets and to assess the correlation between various parameters of a normal aortic valve and personal morphometrics. Methods. The morphometrics of the aortic root were assessed on 54 specimens of the adult heart without any valvular abnormality. We measured following parameters: circumference of the ventriculo-aortic junction and the sino-tubular junction; inter-commissural distance, length of free margin, length of cusp attachment, and height for right coronary, non-coronary, and left coronary aortic leaflets. Results. Based on the average values, the left coronary leaflet is distinguished by the smallest dimensions of the length of free margin and length of cusp attachment. The height of the left coronary leaflet is maximum as compared to the right coronary and non-coronary leaflets, but these differences are minimal (up to 0.2 mm), where the left coronary leaflet is the smallest. Statistically, no significant intergroup difference was found. For all valve sizes, p > 0.05 (inter-commissural distance p = 0.083, length of free margin p = 0.331, length of cusp attachment p = 0.056, height of leaflet p = 0.518). Significant correlations were found between all aortic valve leaflet sizes and the ventriculo-aortic junction and the sino-tubular junction. A weaker correlation was found between all leaflets sizes and the body height.Conclusion. The findings can be used to optimize the leaflet reconstruction and improve the aortic valve function. Received 9 September 2020. Revised 10 September 2021. Accepted 29 June 2022. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Contribution of the authorsConception and study design: R.N. Komarov, V.N. Nikolenko, S.N. OdinokovaData collection and analysis: S.N. Odinokova, V.V. Studennikova, L.O. SeverginaStatistical analysis: S.N. OdinokovaDrafting the article: S.N. Odinokova, R.Kh. BelkharoevaCritical revision of the article: R.N. Komarov, V.N. NikolenkoFinal approval of the version to be published: S.N. Odinokova, R.N. Komarov, V.N. Nikolenko, L.O. Severgina, V.V. Studennikova, R.Kh. Belkharoeva