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      Aortic valve assessment. Anatomical study of 100 healthy human hearts

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          Abstract

          PURPOSE: To assess anatomical characteristics of the aortic valve, so that they may be useful in diagnostic situations and surgical treatment. METHODS: The study analyzed 100 healthy fixed human hearts; 84% of them obtained from males, 61% of them from Caucasian individuals. The ages of the individuals ranged from 9 to 86 years (mean 30±15.5 years). The characteristics assessed related to age, sex, and race were the following: number and height of the cusps, size of the lunulae, internal and external intercommissural distance, position of the coronary ostium in relation to the aortic valve, position of the ventricular septum in relation to the aortic valve, thickness of the cusps. RESULTS: All hearts assessed had a tricuspidal aortic valve. In regard to the height of the cusps and size of the lunula, the left coronary cusp was larger, followed by the right coronary cusp and the noncoronary cusp. The internal and external intercommissural distances had mean values of 24.6±5.7mm and 19.7±7mm, respectively. In regard to the position of the coronary ostia, in one heart two ostia emerged from the left coronary sinus, and in another, the ostium was supracommissural. The mean diameter of the aorta was 21.8±3.6mm, and there were no significant sexual or racial differences, but the diameter increased progressively with the increase in age. The thickness of the cusps did not show any significant difference in the 3 points assessed. CONCLUSION: The aortic valve annulus did not show a perfect circumference, with some variations in the measurements of the annulus, in the cusps and in the relation with the ventricular septum.

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          Most cited references30

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          Cardiac valve surgery: The "French correction"

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            Age-related changes in normal human hearts during the first 10 decades of life. Part I (Growth): A quantitative anatomic study of 200 specimens from subjects from birth to 19 years old.

            Heart weight, ventricular wall thicknesses, and valve circumferences were measured in 200 autopsy specimens of normal hearts from persons who ranged from birth to 19 years old. During this period of body growth, all cardiac measurements increased progressively and correlated with both age and body size (height, weight, and surface area). For most measurements, the mean predicted values were greater in male than in female subjects. Heart weight correlated better with body weight and body surface area than with body height or age of patients. In contrast, ventricular wall thicknesses and valve circumferences correlated better with age of the patients than with measurements of body size. In both sexes at all ages, the thickness of the left ventricle was greater than that of the right ventricle and was generally less than that of the ventricular septum. The circumference of the tricuspid valve usually exceeded that of the mitral valve, but aortic and pulmonary valve circumferences were similar. On the basis of these data, equations were derived and reference tables were constructed to predict normal values for heart weight, ventricular wall thicknesses, and valve circumferences.
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              Growth of the human heart relative to body surface area.

              To determine the growth rate of the human heart in relation to body surface area, normal data obtained by echocardiography and angiocardiography were analyzed with respect to changes in body size occurring between infancy and adulthood. Published data were used to determine the following for 7 theoretical subjects ranging in size from 0.2 m2 (normal newborn) to 2.2 m2 (large adult): average left ventricular (LV) end-diastolic diameter; aortic root diameter; right pulmonary artery diameter; aortic valve area; LV end-diastolic volume; and LV mass. Linear dimensions (LV, aortic and right pulmonary artery diameter) increased as a square root function of surface area and could not be described by a constant "index" of dimension to surface area. Aortic valve area was linearly related to surface area and equalled 3.4 cm2/m2 for subjects of all sizes. LV volume and mass were exponentially related to surface area. This study indicates that intracardiac areas may be indexed for body surface area, but that linear dimensions and volumes have a nonlinear relation to surface area and are more appropriately indexed by surface area to the 0.5 and 1.5 power, respectively.
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                Author and article information

                Journal
                abc
                Arquivos Brasileiros de Cardiologia
                Arq. Bras. Cardiol.
                Sociedade Brasileira de Cardiologia - SBC (São Paulo, SP, Brazil )
                0066-782X
                1678-4170
                July 1999
                : 73
                : 1
                : 81-86
                Affiliations
                [01] orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina orgdiv2Hospital das Clínicas
                Article
                S0066-782X1999000700007 S0066-782X(99)07300107
                10.1590/S0066-782X1999000700007
                10684143
                61dffb1f-58e5-4b94-9996-83317315d9a0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 6
                Product

                SciELO Brazil

                Categories
                Original Articles

                heart,aortic valve,anatomy
                heart, aortic valve, anatomy

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