Document Detail


Aortic and pulmonary root: are their dynamics similar?
MedLine Citation:
PMID:  11825734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The long-term behavior of the pulmonary autograft in the aortic position (Ross procedure) remains uncertain. Using three-dimensional (3D) sonomicrometry (200 Hz) we compared the dynamics of the aortic and pulmonary roots. METHODS: Twenty-four crystals were implanted in each aortic (eight sheep) and pulmonary roots (six sheep) at: base (3 x 2), commissures (3 x 2), sinotubular junction (3 x 2), ascending aorta (3) and pulmonary trunk (3). Under stable hemodynamic conditions, geometric changes were time-related to left ventricular pressure (LV) and aortic pressure. RESULTS: The expansion of the aortic root is twice that of the pulmonary root. During the cardiac cycle, the aortic root volume increased by 37.7 +/- 2.7% (mean +/- SEM) versus 20.9 +/- 1.0% for the pulmonary root. Both were cone-shaped at end diastole. Because expansion at commissures was twice that of the base, both roots became more cylindrical during ejection. Although both roots started to expand prior to ejection and reached maximal expansion during the first third of ejection, the commissural and sinotubular junction dynamics were different in each root. While in the aortic root, expansion at commissural and sinotubular junction levels was significantly different (63.7 +/- 3.6% versus 37.0 +/- 2.1%), in the pulmonary root, they were similar (29.0 +/- 1.3% versus 27.7 +/- 1.4%). Expansion of the three sinuses was also different (P<0.001). In the aortic root: the right expanded more than the left and more than the non-coronary sinus. In the pulmonary root: the right sinus expanded more than the anterior more than the left. CONCLUSIONS: Dynamic differences might explain the global pulmonary root dilatation when subjected to systemic pressure, particularly at the level of the sinotubular junction which might result in the autograft failure. Differences in the asymmetrical expansion of the aortic and pulmonary roots should be considered for the implantation of the pulmonary autograft in the most physiological position.
Authors:
E Lansac; H S Lim; Y Shomura; K H Lim; W Goetz; N T Rice; C Acar; C M G Duran
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  21     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-04     Completed Date:  2002-03-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  268-75     Citation Subset:  IM    
Affiliation:
The International Heart Institute of Montana Foundation at St. Patrick Hospital, 554 West Broadway, Missoula, MT 59802, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Aortic Valve / physiology*,  surgery*
Cardiopulmonary Bypass / methods*
Female
Heart Function Tests
Hemodynamics / physiology*
Linear Models
Male
Models, Animal
Myocardial Contraction / physiology
Pulmonary Valve / physiology*,  surgery*
Sensitivity and Specificity
Sheep

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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