The association between wedging of the aorta and cardiac structural anatomy as revealed using multidetector-row computed tomography

• Shumpei Mori ^[1] ; Robert H. Anderson ^[2] ; Tomofumi Takaya ^[1] ; Takayoshi Toba ^[1] ; Tatsuro Ito ^[1] ; Sei Fujiwara ^[1] ; Yoshiaki Watanabe ^[1] ; Tatsuya Nishii ^[1] ; Atsushi K. Kono ^[1] ; Ken ichi Hirata ^[1]
  1. [1] Kobe University

     Kobe University

     Chuo-ku, Japón

     
  2. [2] Newcastle University

     Newcastle University

     Reino Unido

     
• Localización: Journal of Anatomy, ISSN 0021-8782, Vol. 231, Nº. 1, 2017, págs. 110-120
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • The aortic root is wedged within the cardiac base. The precise extent of aortic wedging, however, and itsinfluence on the surrounding cardiac structures, has not been systematically investigated. We analysed 100consecutive patients, who underwent coronary arterial computed tomographic angiography. We assessed theextent of aortic wedging by measuring the vertical distance between the non-adjacent aortic sinus and theinferior epicardium. A shorter distance indicates deeper aortic wedging. We assessed the tilt angle and diameterof the ascending aorta, the relative heights of the left atrial roof and the oval fossa, the shape of the proximalright coronary artery, the angle of the aorta relative to the left ventricular axis, and the lung volume. The meanextent of wedging was 42.7  9.8 mm. Multivariate analysis revealed that ageing, male gender, increased bodymass index, patients without cardiomyopathy, the extent of tilting and dilation of the ascending aorta, and lungvolume were all independent predictors for deeper aortic wedging (R2= 0.7400, P < 0.0001). The extent ofwedging was additionally correlated with a relatively high left atrial roof (R2= 0.1394, P < 0.0001) and oval fossa(R2= 0.1713, P < 0.0001), the shepherd’s crook shape of the proximal right coronary artery (R2= 0.2376,P < 0.0001), and the narrowness of the angulation of the root relative to the left ventricular axis (R2= 0.2544,P < 0.0001). In conclusion, ageing, male gender, obesity, background cardiac disease, aortic tilting and dilation,and lung volume are all correlated with the extent of wedging of the aortic root within the cardiac base.