Relationship between the membranous septum and the virtual basal ring of the aortic root in candidates for transcatheter implantation of the aortic valve

Knowledge of the anatomy of the membranous septum, as a surrogate to the location of the atrioventricular conduction axis, is a prerequisite for those undertaking transcatheter implantation of the aortic valve (TAVI). Equally important is its relationship of the virtual basal ring. This feature, how...

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Bibliographic Details
Published in:Clinical anatomy (New York, N.Y.) N.Y.), 2018-05, Vol.31 (4), p.525-534
Main Authors: Mori, Shumpei, Tretter, Justin T., Toba, Takayoshi, Izawa, Yu, Tahara, Natsuko, Nishii, Tatsuya, Shimoyama, Shinsuke, Tanaka, Hidekazu, Shinke, Toshiro, Hirata, Ken‐Ichi, Spicer, Diane E., Saremi, Farhood, Anderson, Robert H.
Format: Article
Language:English
Subjects:
aortic stenosis
Aortic valve
Computed tomography
Conduction
Electrocardiography
Impact damage
Implantation
membranous septum
Mitral valve
Septum
transcatheter aortic valve implantation
Ventricle
virtual basal ring
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Summary:Knowledge of the anatomy of the membranous septum, as a surrogate to the location of the atrioventricular conduction axis, is a prerequisite for those undertaking transcatheter implantation of the aortic valve (TAVI). Equally important is its relationship of the virtual basal ring. This feature, however, has yet to be adequately described in the living heart. We analyzed computed tomographic angiographic datasets from 107 candidates (84.1 ± 5.2 years, 68% women) for TAVI. Using multiplanar reconstructions, we measured the height and width of the membranous septum, and the distances of its superior and inferior margins from the virtual basal ring plane. We also assessed the extent of wedging of the aortic root between the mitral valve and the ventricular septum. Mean heights and widths of the membranous septum were 6.6 ± 2.0, and 10.2 ± 3.1 mm, respectively, with its size significantly associated with that of the aortic root (P 
ISSN:0897-3806
1098-2353
DOI:10.1002/ca.23071