Aortic valve leaflet and root dimensions in normal tricuspid aortic
valves: a computed tomography study
Abstract
Background and aim of the study Objective of this analysis was
to use coronary computed tomography in patients with normal tricuspid
aortic valves to perform detailed aortic root and aortic valve geometric
analysis with focus on asymmetry of the three leaflets.
Materials and methods We analyzed aortic valves in 70
anonymized coronary computed tomography angiograms. Mean patient age was
53 ± 11 years. All aortic valves were tricuspid, without calcifications
and aortic roots were of normal dimensions. Asymmetry of the three
leaflets in individual patients was assessed by calculating absolute and
relative differences between the largest and the smallest of the three
leaflets. Results Some degree of asymmetry was present in all
analyzed valves. Absolute and relative differences for free margin
length were 3.2 ± 1.4 mm and 9.3 ± 3.8%, respectively. The largest
relative difference was noted in coaptation area (36.5 ± 16.5%) and the
smallest in leaflet effective height (6.1 ± 4.8%). Using predefined
cut-off criteria for absolute differences in leaflet dimensions, 86% of
the valves were classified as asymmetric. Conclusions Equal
free margin length of the three leaflets is not needed for normal
tricuspid aortic valve function. Aligning the leaflet free margin length
in standardized aortic valve repair may not be necessary in tricuspid
aortic valve repair, whereas equalization of effective leaflet heights
is.