Tool for Measuring Interleflet Triangles in Aortic Root Surgery

  • #AC/AOR 02-EP-3
  • Adult Cardiac Surgery/Aortic. E-POSTER (ORAL) SESSION 2
  • E-Poster (oral)

Tool for Measuring Interleflet Triangles in Aortic Root Surgery

Sergey Y. Boldyrev 1, Angelina Polyakhova 2, Kirill Barbuhatty 1, Vladimir Porhanov 1

Department for Adult Cardiac Surgery, S.V. Ochapowski Regional Hospital 1, Krasnodar, Russia, Krasnodar, Russia; Kuban State medical University , Krasnodar, Russia;

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – C


Introduction. The procedure of reimplantation of the aortic valve into the artificial aorta root is unequivocally shown in the treatment of patients with an aortic aneurysm with aortic insufficiency. However, modern techniques of reimplantation do not give enough attention to the question of how to interpret different parameters of aortic root structures, in particular interleflet triangles, because their enlargement is one of the reasons for the progression of aortic regurgitation.

Objective.We present a new toolpermitting to quickly and clearly identify the interleflet triangles.

Materials and methods. From 2015 to 2017, 15 patients with an aortic aneurysm with aortic insufficiency underwent a reconstruction of the aortic root. All patients had aortic regurgitation (++ / +++).


Of the 15 patients, 6 the corners were ≤ 600, the coaptation zone was within the norm of 5-7 mm. These patients underwent surgery by David procedure. In the other 7 patients, the angles were in the range of 600-900, while the coaptation zone was reduced to 3-4 mm. These patients also underwent modifient reimplantation procedure, after which the coaptation zone increased to 5-7 mm. In two patients, the angles of interleflet triangles were equal to 900, and Bentall procedure was performed. All patients were discharged from the hospital. There were no lethal outcomes.

The conclusion.Understanding the problem of enlargement interleflet triangles can make a significant contribution to the success of surgical correction of aortic insufficiency in patients with an aneurysm of the ascending aorta, by rapid and clear intraoperative determination of the need for a valve-operative procedure or the possibility of preserving its own AV by measuring the interleflet triangles of the AV, which is often a contentious issue in the aortic root surgery, especially for young surgeons.

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