Miazza Jules, Winkel David, Thieringer Florian, Reuthebuch Oliver, Eckstein Friedrich, Gahl Brigitta, Berdajs Denis
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland.
Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Eur J Cardiothorac Surg. 2024 Mar 1;65(3). doi: 10.1093/ejcts/ezae040.
The aortic root (AoR) rotation and its spatial morphology at the base of the heart were postulated but not described in every detail. AoR rotation modalities may play an important role in decision-making during AoR surgery and its outcome. The aim was to provide a detailed spatial anatomy of the AoR rotation and its relation to the vital surrounding structure.
The AoR rotation and its relation to the surrounding structure were assessed in 104 patients with tricuspid aortic valve. The interatrial septum was chosen as a reference to describe AoR rotation that marked the midline of the heart base as a landmark for the AoR rotation direction. Intermediate, clockwise and counterclockwise AoR rotations were defined based on the mentioned reference structures.
The AoR rotation was successfully assessed in 104 patients undergoing ascending aorta and or AoR intervention by multidetector row computed tomography. AoR was positioned normally in 53.8% of cases (n = 56) and rotated counterclockwise in 5.8% (n = 6) and clockwise in 40.4% (n = 42) of cases. In clockwise AoR rotation, the right coronary sinus was positioned in proximity to the right atrium and of the tricuspid valve, whereas in a counterclockwise rotation, the noncoronary sinus was placed over the tricuspid valve just over the membranous septum.
The AoR's rotation can be diagnosed using multidetector row computed tomography. Understanding the anatomy of the aortic valve related to rotational position helps guide surgical decision-making in performing AoR reconstruction.
主动脉根部（AoR）在心脏底部的旋转及其空间形态已被提出，但尚未得到详细描述。AoR旋转方式可能在AoR手术决策及其结果中发挥重要作用。目的是提供AoR旋转的详细空间解剖结构及其与周围重要结构的关系。
在104例三尖瓣主动脉瓣患者中评估AoR旋转及其与周围结构的关系。选择房间隔作为参考来描述AoR旋转，将心脏底部的中线作为AoR旋转方向的标志。基于上述参考结构定义了中间、顺时针和逆时针AoR旋转。
通过多排螺旋计算机断层扫描成功评估了104例接受升主动脉和/或AoR干预患者的AoR旋转。53.8%（n = 56）的病例中AoR位置正常，5.8%（n = 6）的病例中AoR逆时针旋转，40.4%（n = 42）的病例中AoR顺时针旋转。在顺时针AoR旋转中，右冠状动脉窦靠近右心房和三尖瓣，而在逆时针旋转中，无冠状动脉窦位于三尖瓣上方的膜性间隔上方。
可使用多排螺旋计算机断层扫描诊断AoR的旋转。了解与旋转位置相关的主动脉瓣解剖结构有助于指导AoR重建手术的决策。
