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Contemporary Reviews in Interventional Cardiology

Anatomy of the Aortic Valvar Complex and Its Implications for Transcatheter Implantation of the Aortic Valve

Nicoló Piazza, MD; Peter de Jaegere, MD, PhD; Carl Schultz, MD; Anton E. Becker, MD, PhD; Patrick W. Serruys, MD, PhD and Robert H. Anderson, MD, FRCPath

From the Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands (N.P., P.d.J., C.S., P.W.S.); Department of Pathology, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands (A.E.B.); and Cardiac Unit, Institute of Child Health, University College, London, UK (R.H.A.).

Correspondence to Patrick W. Serruys, MD, PhD, Department of Cardiology, Erasmus Medical Center, Thoraxcenter, Ba583a, ’s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. E-mail p.w.j.c.serruys{at}erasmusmc.nl

The books and articles devoted to the anatomy of the aortic valvar complex are numerous. Until now, however, little consideration has been given to understanding the anatomy with percutaneous valvar replacement in mind. It is axiomatic that knowledge of the anatomy of the valve is fundamental in understanding key principles involved in valvar replacement. Such an appreciation of the anatomy helps better understand the optimal positioning for the prosthetic valve within the root of the aorta with respect to the coronary arteries, mitral valve, and the conduction system and may circumvent complications that can arise during its implantation. In this review, therefore, we describe the anatomy of the trifoliate aortic valvar complex and its implications for percutaneous valvar replacement.

Key Words: anatomy • aorta • catheters • stenosis • valves