The aortic root, do we see the 'hole' picture?

Indian J Thorac Cardiovasc Surg

Department of Cardiothoracic Surgery, Royal Brompton and Harefield Hospitals, Hill End Road, Harefield, London, UB9 6JH UK.

Published: September 2024

The aortic root is the segment of the aorta between the left ventricular outflow tract and the sinotubular junction of the ascending aorta, and, on one level, is merely a tube, with a valve at its base, dynamic structures below it, and notable for having the life-limiting coronary arteries originate within its sinuses. However, we propose that the perception of the aortic root has been historically grossly over-simplified by virtue of a bias towards its internal aspect, in terms of coronary ostia and subvalvar relationships through the fibrous skeleton and in so-doing a myocardial component on the external aspect has all but been ignored. This myocardial mass, a component of the left ventricular free wall, is sometimes termed the 'left ostial process' but appears to be rarely, if ever, considered by anatomists, cardiologists, and surgeons alike. By virtue of its direct continuity to the aortic root and proximal left coronary artery, it may have unique roles and, at the very least, deserves greater recognition and investigation. Herein, we propose that it could play a crucial role in cardiac embryology including coronary dominance, and may afford a physiological advantage, to the extent that it may have been selected for in evolutionary terms.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329480PMC
http://dx.doi.org/10.1007/s12055-024-01755-0DOI Listing

Publication Analysis

Top Keywords

aortic root
16
left ventricular
8
aortic
4
root 'hole'
4
'hole' picture?
4
picture? aortic
4
root segment
4
segment aorta
4
aorta left
4
ventricular outflow
4

Similar Publications

Aneurysm rupture is a life-threatening event, yet its underlying mechanisms remain largely unclear. This study investigated the fracture properties of the thoracic aneurysmatic aorta (TAA) using the symmetry-constraint Compact Tension (symconCT) test and compared results to native and enzymatic-treated porcine aortas' tests. With age, the aortic stiffness increased, and tissues ruptured at lower fracture energy [Formula: see text].

View Article and Find Full Text PDF

The study was designed to investigate the impact of N6-methyladenosine (m6A) writer Wilms tumor 1-associated protein (WTAP) on the progression of atherosclerosis (AS) and to further elucidate its possible regulatory mechanism. The m6A levels and WTAP expressions were initially assessed through RIP, qRT-PCR, and western blotting. An in vitro model of AS was constructed by ox-LDL treatment in RAW264.

View Article and Find Full Text PDF

Background: Individuals harbouring pathogenic variants are at risk for aneurysms/dissections throughout the arterial tree. Based on prior reports of sex differences in thoracic aortic aneurysm/dissection, we investigated the sexual dimorphism for vascular events in variant-harbouring patients.

Methods: We analysed two large pedigrees comprising 84 individuals segregating pathogenic missense variants affecting the same p.

View Article and Find Full Text PDF

Transcatheter aortic valve replacement (TAVR) is a common treatment for severe aortic stenosis (AS), but it carries the risk of severe complications, including device embolization. We present a case of a TAVR valve embolization into the left ventricular outflow tract (LVOT), diagnosed with transesophageal echocardiography (TEE) shortly after device deployment. The dislodged valve was successfully retrieved from the LVOT into the aorta, flattened, and stabilized with a thoracic endovascular aneurysm repair (TEVAR) stent, enabling the successful implantation of a new TAVR valve.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the differences between smooth muscle cells (SMCs) from two lineages in the proximal thoracic aorta, specifically the second heart field (SHF) and cardiac neural crest.
  • Researchers used advanced techniques like single-cell RNA sequencing and chromatin accessibility assays to analyze these cells in male mice, identifying distinct gene expressions in both lineages.
  • Findings reveal that SHF-derived SMCs have unique transcriptomic profiles that may influence their functions in thoracic aortic diseases, suggesting lineage-specific roles in vascular health.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!