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Aortic Valve Structure and Function in Relation to Aortic Valve Repair 2nd North American Aortic Valve Repair Symposium Philadelphia, PA Karen M. Kim, M.D. University of Michigan Dept. of Cardiac Surgery Disclosures • None Thanks, Dr. Bavaria! Cook AC et al. Surgical anatomy of the heart. In: Selke FW, del Nido PJ, Swanson SJ, eds., Sabiston & Spencer Surgery of the Chest (8ed). Philadelphia: Elsevier Saunders;2010. p. 702. Cook AC et al. Surgical anatomy of the heart. In: Selke FW, del Nido PJ, Swanson SJ, eds., Sabiston & Spencer Surgery of the Chest (8ed). Philadelphia: Elsevier Saunders;2010. p. 704. de Kerchove L and El Khoury G. Ann Cardiothorac Surg 2013;2(1):57‐64. Khelil N et al. Ann Thorac Surg 2015;99:1220‐7. Lansac E et al. Ann Cardiothorac Surg 2012;2(1):117‐23. Jeanmart H et al. Ann Thorac Surg 2007;83:S746‐51. Contino M et al. Eur J Cardio‐Thoracic Surg 2016;49:93‐100. Contino M et al. Eur J Cardio‐Thoracic Surg 2015;49:93‐100. David TE. Aortic valve‐sparing operations. In: Selke FW and Ruel M, eds., Atlas of Cardiac Surgical Techniques (1ed). Philadelphia: Elsevier Saunders;2010. p. 151. Holubec T et al. Cor et Vasa 2013;55:e479‐86. Schäfers H‐J et al. J Thorac Cardiovasc Surg 2006;132:436‐8. Free margin length Cusp mobility = Length of cusp insertion Average coaptation height decreases with an increase in the STJ/AA ratio Marom G et al. J Thorac Cardiovasc Surg 2013;146:1227‐31. A decrease in AA diameter increases coaptation height and area Marom G et al. J Thorac Cardiovasc Surg 2013;145:406‐11. Leonardo da Vinci’s Eddy Currents within the Sinuses of Valsalva Morea M and De Paulis R. J Cardiovasc Med 2007;8:399‐403. Sievers H‐H and Schmidtke C. J Thorac Cardiovasc Surg 2007;133:1226‐33. Ryan LP et al. J Thorac Cardiovasc Surg 2014;147:1103‐5. References Boodhwani M, El Khoury G, de Kerchove L. Graft sizing for aortic valve sparing surgery. Ann Cardiothorac Surg 2013;2(1):140‐43. Contino M, Mangini A, Lemma MG, Romagnoni C, Zerbi P, Gelpi G, et al. A geometric approach to aortic root surgical anatomy. Eur J Cardio‐Thoracic Surg 2016;29:93‐100. David TE. Aortic valve‐sparing operations. In: Selke FW and Ruel M, eds., Atlas of Cardiac Surgical Techniques (1ed). Philadelphia: Elsevier Saunders;2010. pp. 150‐165. de Kerchove L, Jashari R, Boodhwani M, Duy KT, Lengele B, Gianello P, et al. Surgical anatomy of the aortic root: implication for valve‐sparing reimplantation and aortic valve annuloplasty. J Thorac Cardiovasc Surg 2015;149:425‐33. de Kerchove L, El Khoury G. Anatomy and pathophysiology of the ventriculo‐aortic junction: implication in aortic valve repair surgery. Ann Cardiothorac Surg 2013;2(1):57‐64. De Paulis R, Bassano C, Bertoldo F, Chiariello L. Aortic valve‐sparing operations and aortic root replacement. J Cardiovasc Med 2007;8:97‐101. El Khoury G, de Kerchove L. Principles of aortic valve repair. J Thorac Cardiovasc Surg 2013;145:S26‐9. Jeanmart H, de Kerchove L, Glineur D, Goffinet J‐M, Rougui I, Van Dyck M, et al. Aortic valve repair: the functional approach to leaflet prolapse and valve‐sparing surgery. Ann Thorac Surg 2007;83:S746‐51. References Khelil N, Sleilaty G, Palladino M, Fouda, M, Escande R, Debauchez M, et al. Surgical anatomy of the aortic annulus: landmarks for external annuloplasty in aortic valve repair. Ann Thorac Surg 2015;99:1220‐7. Lansac E, Di Centa I, Vojacek J, Nijs J, Hlubocky J, Mecozzi G, et al. Valve sparing root replacement: the remodeling technqie with external ring annuloplasty. Ann Cardiothorac Surg 2013;2(1):117‐ 23. Morea M, De Paulis R. ‘Il buso’ (the orificie). How much did Leonardo know of the aortic valve? J Cardiovasc Med 2007;8:399‐403. Ryan LP, Levack MM, Gorman JH, III, Gorman RC, Milewski RC, Bavaria JE. Quantitative analysis of 3‐dimensional aortic annular geometry: implication for aortic root reimplantation. J Thorac Cardiovasc Surg 2014;147:1103‐5. Schäfers H‐J, Schmied W, Psych D, Marom G, Aicher D. Cusp height in aortic valves. J Thorac Cardiovasc Surg 2013;146:269‐74. Yacoub MH, Kilner PJ, Birks EJ, Misfeld M. The aortic outflow and root: a tale of dynamism and crosstalk. Ann Thorac Surg 1999;68:S37‐43. Thank you! Go Blue!