Three-Dimensional Understanding of Complexity of the Aortic Root Anatomy as the Basis of Routine Two-Dimensional Echocardiographic Measurements

Abstract

Background: Because the aortic root anatomy is too complicated to evaluate only with 2D methodology, precise appreciation of its 3D anatomy is a prerequisite for all cardiologists and cardiac surgeons. Methods and Results:We provide comprehensive image panels reconstructed from CT datasets to understand the complexity of the aortic root by focusing on the representative longitudinal sections cut through the central zone of coaptation. Conclusions:The provided images will accelerate profound understanding of the 2D long-axis image of the aortic root commonly interrogated with 2D echocardiography, as well as correlated clinical measured values, including the geometric height, effective height, and coaptation length.

Normative Aortic Valvar Measurements in Adults Using Cardiac Computed Tomography ― A Potential Guide to Further Sophisticate Aortic Valve-Sparing Surgery ―

“…19 Precise measurement of the aortic valve requires dedicated 3-dimensional bisecting planes orthogonal to the virtual basal ring (Figure 1). 12,19 Precise measurement of the geometric height requires both nadir of the hingeline and central zone of coaptation. Without projecting the virtual basal ring to the orthogonal plane cut through the central zone of coaptation, the precise effective height cannot be measured.…”

Three‐dimensional volumetric measurement of the aortic root compared to standard two‐dimensional measurements using cardiac computed tomography

“…To date, as far as we are aware, there is no standardized method for measuring the aortic root between the various modalities now used for clinical imaging (Delgado, Schuijf, & Bax, 2010; Erbel et al, 2014; Goldstein et al, 2015; Lang et al, 2015; Mori, Izawa, Shimoyama, & Tretter, 2019). Considering the excellent intra‐ and inter‐observer reliabilities, our current results demonstrate the possibility of clinical management based on volumes measured using cardiac computed tomography.…”

Three‐dimensional visualization of the bovine cardiac conduction system and surrounding structures compared to the arrangements in the human heart

“…One of the classical difficulties in morphology has been to reconstruct three‐dimensional images from two‐dimensional images. Such three‐dimensional reconstructions are particularly needed for the heart because of its complicated morphology (Mori et al 2016b, 2019a, 2019b). The major advantage of virtual dissection is that it enables repetitive cuts to be made from any desired direction.…”