Free margin length and coaptation surface area in normal tricuspid aortic valve: an anatomical study

Abstract

We described the normal dimensions of the FML and coaptation surface in the tricuspid aortic valve. These measurements will serve in the further development of an objective method of free margin shortening based on intraoperative measurements of the FML to treat cusp prolapse and low coaptation after valve-sparing surgery.

Normative Aortic Valvar Measurements in Adults Using Cardiac Computed Tomography ― A Potential Guide to Further Sophisticate Aortic Valve-Sparing Surgery ―

“…20,23-26 Our findings of the longest and shortest free margin length of the right and left coronary aortic leaflets, respectively, was consistent with previous studies. 20,23 This anatomical asymmetry reflect the stress applied to the aortic sinuses, which is also asymmetric. 27,28 Even though both free margin length and geometric height seem to reflect the size of the leaflet, the geometric height of the right coronary aortic leaflet was paradoxically shorter than the other aortic leaflets.…”

The 10 Commandments for Aortic Valve Repair

“…To repeat the anatomic characteristics of the most frequent variant, the tricuspid aortic valve (TAV), 19,20 would be beyond the scope of this paper. Important parameters are sinotubular (ST) and annular diameter, geometric and effective height of the cusps, and commissural height ( Fig.…”

“…39 Effective height is the only quantitative parameter for cusp configuration; its normal value is 9 to 19 mm or 45% of geometric height in TAV. 8,40 It can be determined by echocardiography as well as intraoperatively with a caliper (MSS-1, Fehling Instruments, Karlstein, Germany). In order to obtain reproducible measurements it is important to have sufficient and equal tension on the commissural stay sutures and keep the axis of the caliper in line with the axis of the left ventricular outflow tract.…”

Towards Personalized Aortic Valve Prostheses - A Sparse Representation of the Individual Leaflet Shape

“…The valve apparatus with its three leaflets and the aortic root form a complex biomechanical system where all geometric parameters are interdependant. Especially the size and shape of the three leaflets differs significantly [2]. Studies indicate that even small changes of this specific geometry can cause severe changes in the whole blood cycle, up to an increased short-term mortality [3], [4].…”