{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T11:00:29Z","timestamp":1775905229813,"version":"3.50.1"},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951125001398_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tetralogy of Fallot is the most common cyanotic congenital malformation of the heart. The right ventricular outflow tract is of great interest in this setting, but most of the focus on this feature has been on the size of the so-called pulmonary valvar \u201cannulus\u201d. We aimed to characterise other aspects of the morphology of the pulmonary root in heart specimens with tetralogy of Fallot.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125001398_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed archived hearts with tetralogy of Fallot from four registries. The pulmonary root was examined with specific attention to the number of sinuses, the number of leaflets, presence of any fusion of leaflets, and the direction of the zone of apposition between the leaflets. Cluster analyses were then conducted to see if the features permitted segregation into groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125001398_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We examined a total of 155 hearts. The pulmonary valve had two leaflets in 62%, three leaflets in 34%, and one leaflet in 3%. Irrespective of leaflet morphology, most hearts had two sinuses. Cluster analysis permitted segregation into three groups, with the direction of the zone of apposition being the most important feature for segregation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125001398_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In two-thirds of our hearts with tetralogy of Fallot, the pulmonary valve had two leaflets. Most frequently there were three sinuses. In the setting of a valve with two sinuses, the zone of apposition between the leaflets pointing towards the aorta. Cluster analysis permitted statistically sound segregation of the heart and highlights the importance of delineating these features, specifically the leaflet and sinus morphology, with clinical imaging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951125001398","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T08:35:20Z","timestamp":1742459720000},"page":"978-984","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["The pulmonary valve in tetralogy of Fallot: insights from a necroscopy series"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9116-2835","authenticated-orcid":false,"given":"Rohit S.","family":"Loomba","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-3752","authenticated-orcid":false,"given":"Justin T.","family":"Tretter","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5163-9021","authenticated-orcid":false,"given":"Robert H.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Newcastle University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane E.","family":"Spicer","sequence":"additional","affiliation":[{"name":"Johns Hopkins All Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"S1047951125001398_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.15500"},{"key":"S1047951125001398_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/2150135118757991"},{"key":"S1047951125001398_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.10.050"},{"key":"S1047951125001398_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)65377-4"},{"key":"S1047951125001398_ref13","first-page":"38","article-title":"New concepts in the development and malformation of the arterial valves","volume":"7","author":"Henderson","year":"2020","journal-title":"J Cardiovasc Dev Dis"},{"key":"S1047951125001398_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.17191"},{"key":"S1047951125001398_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-018-1973-x"},{"key":"S1047951125001398_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/joa.13973"},{"key":"S1047951125001398_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14321"},{"key":"S1047951125001398_ref14","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00304.2009"},{"key":"S1047951125001398_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S104795112100281X"},{"key":"S1047951125001398_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2023.03.023"},{"key":"S1047951125001398_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/21501351211032919"},{"key":"S1047951125001398_ref8","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.695876"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951125001398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T10:29:35Z","timestamp":1775903375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951125001398\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["S1047951125001398"],"URL":"https:\/\/doi.org\/10.1017\/s1047951125001398","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}