Cardiac valve bioprosthesis frames and donor aortic valve commissural spacing

Abstract

Intercommissural distances in 300 porcine and 200 human aortic valves were expressed as percentages of the smallest dimension. The right coronary cusp was generally the largest but whereas in porcine valves the noncoronary cusp was generally the smallest, in human valves this status was shared about equally between the noncoronary and left coronary cusps. The dominant pattern was with all three dimensions unequal (difference > 5%). Seventy-seven percent of the porcine valves and 84% of the human valves were in this category. The asymmetry existed in both clockwise and anticlockwise directions. Accurate concordance between the valve commissures and supporting frame struts is essential in the fabrication of bioprosthetic cardiac valves and the optimum utilisation of donor aortic valves would result from using frames in which the strut angles were 110°, 120°, 130° for porcine valves and 111°, 120°, 129° for human valves, in both clockwise and anticlockwise patterns.