Journal
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
Volume 49, Issue 4, Pages 1213-1221Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ejcts/ezv295
Keywords
Aortic root; Geometry of the aortic root; Shear stress; Computed fluid dynamics
Funding
- Swiss Heart Foundation, Bern, Switzerland
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The aim was to define the 3-dimensional (3D) geometrical changes of the aortic root and to determine the local shear stress profile of aortic root elements during the cardiac cycle. Six sonomicrometric crystals (200 Hz) were implanted into the aortic root of five pigs at the commissures and at the aortic root base (AoB). 3D aortic root deformation including volume, torsion and tilt angle were determined. Geometrical data with measured local flow and pressure conditions was used for computed fluid dynamics modelling of the aortic root. Compared with end-diastole, the sinotubular junction and AoB have maximal expansion at peak ejection: 16.42 +/- 6.36 and 7.60 +/- 2.52%, and minimal at isovolaemic relaxation: 2.87 +/- 1.62 and 1.85 +/- 1.79%. Aortic root tilt and rotation angle were maximal at the end of diastole: 17.7 +/- 8.8 and 21.2 +/- 2.09A degrees, and decreased to 15.24 +/- 8.14 and 18.3 +/- 0.1.94A degrees at peak ejection. High shear stress > 20 Pa was registered at peak ejection at coaptations, and during diastole at the superior two-thirds of the leaflets and intervalvular triangles (IVTs). The leaflet body, inferior one-third of the IVTs and valve nadir were exposed to moderate shear stress (8-16 Pa) during the cardiac cycle. Aortic root geometry demonstrates precise 3D changes of tilt and rotation angle. Reduction of angles during ejection results in a straight cylinder with low shear stress that facilitates the ejection; the increase during diastole results in a tilted frustum with elevated shear stress. Findings can be used for comparative analysis of native and synthetic structures with individual compliance.
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