Geometrical model of the pulmonary root.

Background And Aim Of The Study: The renaissance of the Ross procedure has attracted much attention to the clinical anatomy of the pulmonary valve. Within the reviewed literature which emphasizes the morphology of the pulmonary root, no detailed anatomy has been reported. The study aim was to describe the cardiosurgical-orientated anatomy of the pulmonary valve.

Methods: Morphometric measurements were made on 20 fixed normal pulmonary roots. The roots were fixed under diastolic pressure (5 mmHg) with closed leaflets. The distances between the commissures, and between the intervalvular triangles, were measured. The heights of the sinuses and of the intervalvular triangles were also defined.

Results: The mean (+/- SD) of each parameter was calculated. The distances of the right, left and anterior sinus commissures were approximately similar, as were the distances of the intervalvular triangles at the root base. The mean height of the left coronary sinus was maximal, followed by the right and anterior pulmonary sinuses. The left intervalvular triangle was highest, followed by the posterior and right intervalvular triangles. The difference between the height of the left sinus and right intervalvular triangle indicated a tilt angle of 16.26 degrees between the root base and sinotubular junction.

Conclusion: Based on these measured parameters, a spatial geometrical model was constructed which clearly described the asymmetrical structure of the pulmonary root.