{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T13:50:20Z","timestamp":1785592220036,"version":"3.56.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"BioStable Science and Engineering Inc"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In chronic aortic insufficiency (AI), the method and degree of annular downsizing required to achieve durable coaptation in aortic valve repair (AVr) remains poorly defined. This study evaluated the relationship between leaflet size and annular diameter to predict adequate annular sizing in remodeling AVr.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Under regulatory supervision, 74 patients with chronic tri-leaflet AI underwent AVr using ring annuloplasty and leaflet reconstruction. Fifty-four (73%) had ascending aortic ( n = 25) and\/or root ( n = 29) aneurysms, and aortic grafts were sized 5 to 7 mm larger than the rings. Intraoperatively, leaflet free-edge length (FEL) was measured with special ball sizers positioned in the coronary sinus, and \u201cnormal\u201d annular diameter was predicted from the validated formula: Required \u201cnormal\u201d diameter = FEL\/1.5. \u201cNormal\u201d annular diameters predicted from FEL were compared with pathologic diameters measured intraoperatively with Hegar dilators, and both were correlated with gender, age, and BSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Average age was 62.1 \u00b1 13.3 years (mean \u00b1 SD), 73% (54\/74) were male, and 96% (71\/74) had moderate-to-severe AI. All patients had annular dilatation, with a pathologic diameter 26.6 \u00b1 2.3 mm before repair, and a predicted \u201cnormal\u201d diameter of 21.7 \u00b1 1.7 mm ( P &lt; 0.001). Both predicted and pathologic annular diameters were larger in men ( P &lt; 0.001), but no relationship existed with age. BSA correlated with both predicted and pathologic diameters, although variability was large.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on a simple validated method to predict \u201cnormal\u201d annular diameter, all patients with chronic AI have some degree of annular dilatation. This finding implies that most AVr should include annuloplasty, with adequate and precise annular reduction based on leaflet size.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1556984521997422","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T13:58:51Z","timestamp":1616075931000},"page":"267-272","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Leaflet Dimensions as a Guide to Remodeling Annuloplasty During Aortic Valve Repair"],"prefix":"10.1177","volume":"16","author":[{"given":"Marek J.","family":"Jasinski","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Wroclaw Medical University, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Scott","family":"Rankin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Mazzitelli","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Klinikum Bogenhausen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-3590","authenticated-orcid":false,"given":"Theodor","family":"Fischlein","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Klinikum N\u00fcrnberg, Paracelsus Medical University, N\u00fcrnberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeong-Hoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Thoracic Surgery, Klinik f\u00fcr Herzchirurgie Kerckhoff-Klinik, Justus-Liebig-Universit\u00e4t Gie\u00dfen, Bad Nauheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence M.","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2174-1321","authenticated-orcid":false,"given":"Marek A.","family":"Deja","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Badhwar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"bibr1-1556984521997422","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(00)70092-4"},{"key":"bibr2-1556984521997422","first-page":"105","volume":"2","author":"de Kerchove L.","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"bibr3-1556984521997422","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv050"},{"key":"bibr4-1556984521997422","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2005.12.055"},{"key":"bibr5-1556984521997422","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.11.059"},{"key":"bibr6-1556984521997422","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.06.043"},{"key":"bibr7-1556984521997422","first-page":"179","volume":"17","author":"Rankin JS.","year":"2008","journal-title":"J Heart Valve 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