The ideal theoretical graft oversizing in valve-sparing aortic operations with a standard tubular or a Valsalva graft

Daniele Maselli, Gabriele Borelli, Andrea Amerini, Pietro Bajona, Luca Bellieni, Mariagrazia Croccia, Gaetano Minzioni

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: We sought to determine, by a mathematical model, the ideal theoretical degree of ascending aortic graft oversizing needed to obtain normal sinuses dimension in the reimplantation type of valve-sparing aortic operations. Methods: To define a normal-range value, size of sinuses of Valsalva was conventionally expressed as the area surrounding fully opened aortic cusps, the so-called beyond leaflets area (BLA), and measured in 50 healthy subjects. A mathematical relationship between aortic annulus diameter, aortic sinuses diameter and resulting BLA was defined. By simulating intra-operative scenarios, the effect of different degrees of a standard or Valsalva graft oversizing on BLA extension was tested. Results: The same degree of graft oversizing resulted in a bigger beyond leaflets area for the Valsalva graft than for a standard graft. Oversizing degrees exceeding +7 mm for a standard graft and +3 mm for the Valsalva graft resulted in a beyond leaflets area over normal limits. Results were expressed in a visual form as two different normograms, one for the standard graft and one for the Valsalva graft. Conclusions: A less pronounced graft oversizing is needed to achieve normal-range sinuses size when using a Valsalva graft, the ideal theoretical graft oversizing was +7 mm for a standard graft and +3 mm for the Valsalva graft, our normograms can be helpful in selecting a proper graft size when performing a valve-sparing aortic procedure.

Original languageEnglish (US)
Pages (from-to)845-849
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Volume28
Issue number6
DOIs
StatePublished - Dec 2005

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Aortic Valve
Transplants
Sinus of Valsalva
Reference Values
Theoretical Models
Replantation
Healthy Volunteers

Keywords

  • Aortic root sizing
  • Aortic valve reimplantation
  • Aortic valve-sparing operation
  • Sinuses of Valsalva

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

The ideal theoretical graft oversizing in valve-sparing aortic operations with a standard tubular or a Valsalva graft. / Maselli, Daniele; Borelli, Gabriele; Amerini, Andrea; Bajona, Pietro; Bellieni, Luca; Croccia, Mariagrazia; Minzioni, Gaetano.

In: European Journal of Cardio-thoracic Surgery, Vol. 28, No. 6, 12.2005, p. 845-849.

Research output: Contribution to journalArticle

Maselli, Daniele ; Borelli, Gabriele ; Amerini, Andrea ; Bajona, Pietro ; Bellieni, Luca ; Croccia, Mariagrazia ; Minzioni, Gaetano. / The ideal theoretical graft oversizing in valve-sparing aortic operations with a standard tubular or a Valsalva graft. In: European Journal of Cardio-thoracic Surgery. 2005 ; Vol. 28, No. 6. pp. 845-849.
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abstract = "Objective: We sought to determine, by a mathematical model, the ideal theoretical degree of ascending aortic graft oversizing needed to obtain normal sinuses dimension in the reimplantation type of valve-sparing aortic operations. Methods: To define a normal-range value, size of sinuses of Valsalva was conventionally expressed as the area surrounding fully opened aortic cusps, the so-called beyond leaflets area (BLA), and measured in 50 healthy subjects. A mathematical relationship between aortic annulus diameter, aortic sinuses diameter and resulting BLA was defined. By simulating intra-operative scenarios, the effect of different degrees of a standard or Valsalva graft oversizing on BLA extension was tested. Results: The same degree of graft oversizing resulted in a bigger beyond leaflets area for the Valsalva graft than for a standard graft. Oversizing degrees exceeding +7 mm for a standard graft and +3 mm for the Valsalva graft resulted in a beyond leaflets area over normal limits. Results were expressed in a visual form as two different normograms, one for the standard graft and one for the Valsalva graft. Conclusions: A less pronounced graft oversizing is needed to achieve normal-range sinuses size when using a Valsalva graft, the ideal theoretical graft oversizing was +7 mm for a standard graft and +3 mm for the Valsalva graft, our normograms can be helpful in selecting a proper graft size when performing a valve-sparing aortic procedure.",
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