Investigation of the Mathematical Relationship between the Aortic Valve and Aortic Root: Implications for Precise Guidance in Aortic Valve Repair

Background: The study was aimed at investigating the mathematical relationship between the aortic valve and aortic root through CTA imaging-based reconstruction. Methods: We selected 121 healthy participants and analyzed the measurements of aortic root dimensions, including the sinotubular junction (SJT), ventriculo-arterial junction (VAJ), maximum sinus diameter (SD), sinus height (SH), effective height (eH) and coaptation height (cH). We also reconstructed 3-D aortic valve cusps using CTA imaging to calculate the aortic cusp surface areas. Data were collected to analyze the ratios and the correlation between aortic valve and aortic root dimensions. Results: Among healthy participants, the STJ was approximately 10% larger than the VAJ, and the SD was 1.375 times larger than the VAJ. The average eH and cH were 8.94 mm and 3.62 mm, respectively. The aortic cusp surface areas were larger in men than women. Regardless of sex, the non-coronary cusp was found to be largest, and was followed by the right coronary cusp and the left coronary cusp. Although the aortic root dimensions were also significantly larger in in men than women, the STJ to VAJ, SD to VAJ, and SH to VAJ ratios did not significantly differ by sex. The mathematical relationship between the aortic cusp surface areas and VAJ orifice area was calculated as aortic cusp surface areas (mm(2)) = 1.512x{VAJ(mm)/2}(2) x pi + 166.866. Conclusions: The aortic root has specific geometric ratios. The mathematical relationship between the aortic valve and aortic root might be used to guide aortic valve repair.