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European Journal of Echocardiography Advance Access published online on December 6, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen314
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Structure and anatomy of the aortic root

Siew Yen Ho1,2,*

1 Cardiac Morphology Unit National Heart & Lung Institute, Imperial College London, Dovehouse Street, London SW3 6LY, UK
2 Royal Brompton Hospital, London, UK

Received 28 July 2008; accepted after revision 16 November 2008.

* Corresponding author. Tel: +44 207 3518751; fax: +44 207 3518230. E-mail address: yen.ho{at}imperial.ac.uk


  Abstract

The aortic root is a composite structure of several elements, not only the valvar leaflets. Understanding its central location in the heart is crucial to understanding the anatomy of the aortic root and why its location impacts on interventional procedures in and around the root. The valvar leaflets have a unique shape with deep closure lines buttressed by the nodule of Arantius. The scalloped configuration of the hingelines of the leaflets cross the ventriculo-arterial junction, leaving interleaflet fibrous triangles between the sinuses that are anatomically aortic but haemodynamically ventricular. Variations in leaflet structure and their arrangements result in valvar stenosis or regurgitation, or both. Often, diseases of the aortic root involve more than one structural element. The leaflets and their hingelines, aortic sinuses, interleaflets triangles sinutubular junction, and ventriculo-arterial junction and their structures adjoining the junctions need to be taken into account when considering the aortic root.

Keywords: Aortic valve; Anatomy; Aortic stenosis; Aortic regurgitation; Bicuspid aortic valve; Intervention


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