Dong Hyun Yang MD, Presenter: Nothing to Disclose

Joon-Won Kang MD, Abstract Co-Author: Nothing to Disclose

Namkug Kim PhD, Abstract Co-Author: Stockholder, Coreline Soft, Inc

Jae-Kwan Song MD, PhD, Abstract Co-Author: Nothing to Disclose

Tae-Hwan Lim MD, PhD, Abstract Co-Author: Nothing to Disclose

In vivo geometric analysis of the normal human aortic root is lacking. The aim of this study was to obtain the comprehensive geometric data of the normal aortic root using computed tomography (CT). 

One hundred thirty subjects who underwent cardiac CT for atypical chest pain or health check-up were enrolled. Subjects without hypertension, diabetes, significant coronary artery disease, and cardiac valvular dysfunction were included (mean age, 51.4 years; 55 men; number of subjects in each decade – third 15, forth 20, fifth 30, sixth 21, seventh 23, and eighth 21). Mid-diastolic phase of CT images were analyzed using customized software (Omni4D). Individual volume of the aortic sinus and leaflet surface areas (LSA) of the right, left and non-coronary cusps were measured. Intercommissural (IC) distance in each aortic sinus was also investigated. All measured parameters were indexed to body surface area.

The left coronary sinus showed significantly smaller geometric parameters including sinus volume, LSA, and IC distance than the other two sinuses (left/non-coronary/right: sinus volume [ml/m2] 1.54/1.95/2.08; LSA [cm2/m2] 2.56/3.03/3.03; IC distance [cm/m2] 1.84/1.94/2.23; p <0.001). Between the right- and non-coronary sinuses, there were no significant differences other than IC distance. In the older decade of age, the volume and IC distance of all coronary sinuses showed an increasing tendency on the test for trend (p < 0.05). However, no significant difference was found in the LSA and annular area with age. 

Detailed analysis of aortic root geometry reveals normal asymmetry in the aortic sinus and leaflet surface area. The size of left coronary sinus was smaller than the other two sinuses. The size of aortic sinus showed increasing tendency in older age group, however LSA did not changed with age.

Knowledge of the normal aortic root anatomy is relevant to understand the pathophysiology of the aortic regurgitation and to improve the method of surgical aortic root reconstruction.

Yang, D, Kang, J, Kim, N, Song, J, Lim, T, In Vivo Assessment of Aortic Root Geometry in Normal Controls Using 3-Dimensional Analysis of Computed Tomography.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005533.html