The aortic outflow and root: A tale of dynamism and crosstalk

Although the aortic outflow and root (AoR) constitute a short channel conne cting the left ventricle to the aorta, its different components have been s hown to be highly specialized structures, interacting with each other as we ll as with surrounding structures, thus providing a "tale of dynamism and c rosstalk." Thorough knowledge of the AoR and morphological and structural c hanges, that occur during pathological processes, can have important implic ations in evolving and executing surgical Procedures designed to presence a nd restore the "dynamism and crosstalk." The crown-shaped annulus, fibrous trigones, aortic cusps components, aortic sinuses, and the sinotubular junc tion share a dynamic coordinated behavior, which can be partially or comple tely restored in various repair or replacement procedures of the AoR. The i nteraction and the specific operations are presented with evidence supporti ng the notion that the dynamic behavior of the root does influence the patt ern of instantaneous movements of the aortic cusps after different types of operations. Further studies are required to evaluate the influence of adop ting these ideas on the long-term results of operative procedures. (C) 1999 by The Society of Thoracic Surgeons.