{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T04:24:26Z","timestamp":1746419066658,"version":"3.37.3"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T00:00:00Z","timestamp":1544918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,2]]},"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>)\u2010sparing 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>\u2010sparing 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\u00a0\u2264\u00a0mild <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content>, n\u00a0=\u00a013; Group 2\u00a0\u2265\u00a0moderate <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content>, n\u00a0=\u00a010) and 25 Controls. To determine the changes in <jats:styled-content style=\"fixed-case\">AV<\/jats:styled-content>\u2010sparing operations, a subgroup of 15 patients were examined pre\u2010 and post surgery. 3D\u2010<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\u2010commissural 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>\u00a0=\u00a00.001) with shorter coaptation height (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). In patients undergoing <jats:styled-content style=\"fixed-case\">AV<\/jats:styled-content>\u2010sparing 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>\u00a0=\u00a00.001) with greater coaptation height (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and smaller inter\u2010commissural distances (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/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\u2010sparing 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>","DOI":"10.1111\/echo.14216","type":"journal-article","created":{"date-parts":[[2018,12,17]],"date-time":"2018-12-17T06:04:20Z","timestamp":1545026660000},"page":"376-385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Aortic root changes before and after surgery for chronic aortic dilatation: A 3D echocardiographic study"],"prefix":"10.1111","volume":"36","author":[{"given":"Flavia","family":"Ballocca","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Management Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"Division of Cardiology Citt\u00e0 della Salute e Della Scienza University of Turin  Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia 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