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Eur J Cardiothorac Surg 2005;27:831-835
© 2005 Elsevier Science NL

A normogram to anticipate dimension of neo-sinuses of valsalva in valve-sparing aortic operations

^a Department of Cardiac Surgery, S. Camillo Hospital, Rome, Italy
^b Department of Cardiology, S. Camillo Hospital, Rome, Italy

Received 2 November 2004; received in revised form 24 January 2005; accepted 25 January 2005.

^* Corresponding author. Address: Divisione di Cardiochirurgia, Dipartimento Cardiotoracico, Azienda Ospedaliera Pisana, Via Paradisa No. 2, 56124 Pisa, Italy. Tel.: +39 50 995 261; fax: +39 50 995 278. (E-mail: dmaselli{at}tiscali.it).

Objective: The aim of the present study was to define a method to pre-determine the correct size of neo-sinuses of Valsalva in the reimplantation type of valve-sparing aortic operation. Methods: The objective was achieved in three steps: (1) evaluation in the healthy population, of the normal size of sinuses of Valsalva expressed as the area surrounding fully opened aortic cusps, the so-called beyond leaflets area; (2) elaboration of a normogram by which, given a known annular diameter, it is possible to select the appropriate graft size to obtain a normal beyond leaflets area; (3) validation of the normogram by comparing, in a population of 20 patients undergoing a valve-sparing procedure, the predicted and observed beyond leaflets area. Results: The following values for beyond leaflets area were observed: mean normal 320.6±120.6mm², mean predicted 355±63.2mm², mean observed 364.7±72.8mm².No significant differences were obtained for predicted versus observed values. Regression analysis showed a linear distribution with an r value of 0.95. Conclusions: We proposed a simplified approach for sizing of the neo-aortic root in the reimplantation type of valve-sparing aortic operation focussed on the size of sinuses of Valsalva. Our normogram showed to be reliable in anticipating beyond leaflets area. It can be helpful in avoiding the selection of an undersized or excessively oversized graft.

Key Words: Aortic valve-sparing operation • Sinuses of Valsalva • Aortic valve reimplantation • Aortic root aneurysm • Aortic regurgitation • Aortic root sizing

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				D. Maselli, G. Borelli, A. Amerini, P. Bajona, L. Bellieni, M. Croccia, and G. Minzioni The ideal theoretical graft oversizing in valve-sparing aortic operations with a standard tubular or a Valsalva graft Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 845 - 849. [Abstract] [Full Text] [PDF]