{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:03:29Z","timestamp":1753877009970,"version":"3.41.2"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study aimed to classify anatomical variations in aortic root rotation using preoperative three-dimensional transoesophageal echocardiography (3D-TEE), validate these findings with cardiac computed tomography (CT) in patients undergoing mitral valve surgery and evaluate the clinical impact on postoperative atrioventricular conduction disorders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A total of 126 patients with normal electrocardiograms who underwent isolated mitral valve surgery were included. Anatomical variation was diagnosed using 3D-TEE, and aortic root rotation angle was measured using cardiac CT. New-onset postoperative atrioventricular block (AVB) and bundle branch block were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Variations of aortic root rotation were classified by 3D-TEE into two categories: \u2018center rotation\u2019 (normal) (85.7%, n\u2009=\u2009108\/126), where the commissure of the left and non-coronary aortic leaflet was located at center of the anterior mitral leaflet, and \u2018lateral rotation\u2019 (14.3%, n\u2009=\u200918\/126), rotated to the lateral trigone side. The aortic root rotation angle, where the interatrial septum was defined as a reference, measured by cardiac CT strongly correlated with 3D-TEE findings (\u2018center rotation\u2019 vs \u2018lateral rotation\u2019: 51.6\u00b0 vs 64.6\u00b0, P\u2009&amp;lt;\u20090.001). The incidence of new-onset conduction disorder, all presenting with first-degree AVB, was significantly higher in the \u2018lateral rotation\u2019 than in the \u2018center rotation\u2019 (38.9% [n\u2009=\u20097\/18] vs 5.6% [n\u2009=\u20096\/108], P\u2009&amp;lt;\u20090.001). Aortic root rotation angles were identified as significant risk factors for postoperative first-degree AVB (odds ratio, 1.05; 95% confidential interval, 1.01\u20131.09; P\u2009=\u20090.027), with cutoff values of 58.7\u00b0 predicting persistent new-onset AVB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Aortic root rotation angle measured by cardiac CT validated 3D-TEE diagnosis of \u2018lateral rotation\u2019 of the aortic root. \u2018Lateral rotation\u2019 and larger aortic root rotation angles were significant risk factors for postoperative first-degree AVB following mitral valve surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf046","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T21:50:16Z","timestamp":1741125016000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of aortic root rotation angle on new-onset first-degree atrioventricular block following mitral valve surgery"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6080-2166","authenticated-orcid":false,"given":"Kazuma","family":"Handa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0695-3203","authenticated-orcid":false,"given":"Masashi","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4656-7317","authenticated-orcid":false,"given":"Daisuke","family":"Yoshioka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuji","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Misumi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4329-2520","authenticated-orcid":false,"given":"Sho","family":"Komukai","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics, Department of Integrated Medicine, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-0580","authenticated-orcid":false,"given":"Tetsuhisa","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine , Osaka,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Miyagawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , 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