Anatomic Correlation of Posterior Aortic Root Enlarging Incisions

Objectives: To clarify the terms surrounding the posterior aortic root enlarging incisions and correlate them anatomically.

Methods: This is a human cadaveric heart study in which measurements were taken along the path of the named incisions in 42 normal and congenitally malformed hearts using calipers.

Results: Our results indicate that there is a variable overlap of the left atrial wall with the anterior mitral leaflet and the aorta and that in individual cases it may not be possible to accurately predict the possibility of enlarging the root without opening the left atrium, though some papers suggest otherwise.

Conclusion: Names associated with incisions are best avoided. Rather they should be described anatomically. Incision between the noncoronary sinus of Valsalva and left coronary sinus of Valsalva may be the safest approach to enlarging the root.