{"doi":"10.1111/echo.14216","title":"Aortic root changes before and after surgery for chronic aortic dilatation: A 3D echocardiographic study","abstract":"<jats:sec><jats:title>Background</jats:title><jats:p>Quantitative 3D assessment of the aortic root may improve planning and success of aortic valve (<jats:styled-content style=\"fixed-case\">AV</jats:styled-content>)‐sparing operations.</jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p>To use 3D transesophageal echocardiography (<jats:styled-content style=\"fixed-case\">TEE</jats:styled-content>) to assess the effect of chronic aortic dilatation on aortic root shape and aortic regurgitation (<jats:styled-content style=\"fixed-case\">AR</jats:styled-content>) severity and to examine the effects of <jats:styled-content style=\"fixed-case\">AV</jats:styled-content>‐sparing operations.</jats:p></jats:sec><jats:sec><jats:title>Methods and Results</jats:title><jats:p>To determine the changes with chronic aortic dilatation, we studied 48 patients, 23 with aortic dilatation (Group 1 ≤ mild <jats:styled-content style=\"fixed-case\">AR</jats:styled-content>, n = 13; Group 2 ≥ moderate <jats:styled-content style=\"fixed-case\">AR</jats:styled-content>, n = 10) and 25 Controls. To determine the changes in <jats:styled-content style=\"fixed-case\">AV</jats:styled-content>‐sparing operations, a subgroup of 15 patients were examined pre‐ and post surgery. 3D‐<jats:styled-content style=\"fixed-case\">TEE</jats:styled-content> images were analyzed using multiplanar reconstruction (<jats:styled-content style=\"fixed-case\">QLAB</jats:styled-content>, Philips, Philips Medical Systems, Andover, MA, USA) to obtain aortic root areas, diameters, and lengths. We also calculated a novel parameter called total coaptation surface area (<jats:styled-content style=\"fixed-case\">TC</jats:styled-content>oap<jats:styled-content style=\"fixed-case\">SA</jats:styled-content>), which sums the contact surface area of all the <jats:styled-content style=\"fixed-case\">AV</jats:styled-content> cusps. Compared to Controls, Groups 1 and 2 had significantly larger aortic root areas, inter‐commissural distances, and cusp heights. Compared to Group 1 and Controls, Group 2 had significantly smaller <jats:styled-content style=\"fixed-case\">TC</jats:styled-content>oap<jats:styled-content style=\"fixed-case\">SA</jats:styled-content> when adjusted for aortic annular area (<jats:italic>P</jats:italic> = 0.001) with shorter coaptation height (<jats:italic>P</jats:italic> &lt; 0.001). In patients undergoing <jats:styled-content style=\"fixed-case\">AV</jats:styled-content>‐sparing surgery, <jats:styled-content style=\"fixed-case\">TC</jats:styled-content>oap<jats:styled-content style=\"fixed-case\">SA</jats:styled-content> was significantly larger post surgery (<jats:italic>P</jats:italic> = 0.001) with greater coaptation height (<jats:italic>P</jats:italic> &lt; 0.001) and smaller inter‐commissural distances (<jats:italic>P</jats:italic> &lt; 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The aortic valve is a dynamic structure that remodels in response to aortic dilatation. Successful valve‐sparing surgery corrects these changes. Quantitative modeling of the aortic valve and root could potentially improve the repair to the individual patients and modify outcomes.</jats:p></jats:sec>","journal":"Echocardiography","year":2019,"id":683977,"datarank":0.24141568686511508,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.0,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1786853,"name":"Giulia Maria Ruggeri","orcid":null,"position":1,"is_corresponding":false},{"id":1786854,"name":"Andrew Roscoe","orcid":null,"position":2,"is_corresponding":false},{"id":1786855,"name":"Babitha Thampinathan","orcid":null,"position":3,"is_corresponding":false},{"id":1786856,"name":"Tirone Esperidiao David","orcid":null,"position":4,"is_corresponding":false},{"id":63714,"name":"Roberto M. Lang","orcid":"0000-0003-3723-1577","position":5,"is_corresponding":false},{"id":1786857,"name":"Massimiliano Meineri","orcid":"0000-0001-5224-6721","position":6,"is_corresponding":false},{"id":88214,"name":"Wendy Tsang","orcid":"0000-0003-2356-4805","position":7,"is_corresponding":false},{"id":1786852,"name":"Flavia Ballocca","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Aortic root changes before and after surgery for chronic aortic dilatation: A 3D echocardiographic study","abstract":"<jats:sec><jats:title>Background</jats:title><jats:p>Quantitative 3D assessment of the aortic root may improve planning and success of aortic valve (<jats:styled-content style=\"fixed-case\">AV</jats:styled-content>)‐sparing operations.</jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p>To use 3D transesophageal echocardiography (<jats:styled-content style=\"fixed-case\">TEE</jats:styled-content>) to assess the effect of chronic aortic dilatation on aortic root shape and aortic regurgitation (<jats:styled-content style=\"fixed-case\">AR</jats:styled-content>) severity and to examine the effects of <jats:styled-content style=\"fixed-case\">AV</jats:styled-content>‐sparing operations.</jats:p></jats:sec><jats:sec><jats:title>Methods and Results</jats:title><jats:p>To determine the changes with chronic aortic dilatation, we studied 48 patients, 23 with aortic dilatation (Group 1 ≤ mild <jats:styled-content style=\"fixed-case\">AR</jats:styled-content>, n = 13; Group 2 ≥ moderate <jats:styled-content style=\"fixed-case\">AR</jats:styled-content>, n = 10) and 25 Controls. To determine the changes in <jats:styled-content style=\"fixed-case\">AV</jats:styled-content>‐sparing operations, a subgroup of 15 patients were examined pre‐ and post surgery. 3D‐<jats:styled-content style=\"fixed-case\">TEE</jats:styled-content> images were analyzed using multiplanar reconstruction (<jats:styled-content style=\"fixed-case\">QLAB</jats:styled-content>, Philips, Philips Medical Systems, Andover, MA, USA) to obtain aortic root areas, diameters, and lengths. We also calculated a novel parameter called total coaptation surface area (<jats:styled-content style=\"fixed-case\">TC</jats:styled-content>oap<jats:styled-content style=\"fixed-case\">SA</jats:styled-content>), which sums the contact surface area of all the <jats:styled-content style=\"fixed-case\">AV</jats:styled-content> cusps. Compared to Controls, Groups 1 and 2 had significantly larger aortic root areas, inter‐commissural distances, and cusp heights. Compared to Group 1 and Controls, Group 2 had significantly smaller <jats:styled-content style=\"fixed-case\">TC</jats:styled-content>oap<jats:styled-content style=\"fixed-case\">SA</jats:styled-content> when adjusted for aortic annular area (<jats:italic>P</jats:italic> = 0.001) with shorter coaptation height (<jats:italic>P</jats:italic> &lt; 0.001). In patients undergoing <jats:styled-content style=\"fixed-case\">AV</jats:styled-content>‐sparing surgery, <jats:styled-content style=\"fixed-case\">TC</jats:styled-content>oap<jats:styled-content style=\"fixed-case\">SA</jats:styled-content> was significantly larger post surgery (<jats:italic>P</jats:italic> = 0.001) with greater coaptation height (<jats:italic>P</jats:italic> &lt; 0.001) and smaller inter‐commissural distances (<jats:italic>P</jats:italic> &lt; 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The aortic valve is a dynamic structure that remodels in response to aortic dilatation. Successful valve‐sparing surgery corrects these changes. Quantitative modeling of the aortic valve and root could potentially improve the repair to the individual patients and modify outcomes.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"26207759","pmcid":null,"openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/echo.14216","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/echo.14216","host_type":"publisher"}],"fields_of_study":[],"mesh_terms":[],"keywords":[],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-18T12:56:33.309751Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}