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Quantification of Aortic Cusp Parameters Using Computed Tomography in Valve-Sparing Aortic Root Replacement Surgery: A Prospective Study

Year: 2026
Type: article
Study design: Observational Study
Abstract: PURPOSE: Determining the feasibility of valve-sparing aortic root replacement (VSRR) requires accurate preoperative assessment of aortic valve cusp geometry. However, the reliability of computed tomography (CT) for measuring cusp parameters remains unclear. This study evaluated the agreement between CT-derived cusp measurements and intraoperative measurements and explored the potential of CT-based cusp asymmetry to predict intraoperative cusp plication. MATERIALS AND METHODS: In this prospective study, 32 consecutive patients undergoing VSRR with the reimplantation technique were enrolled. Preoperative CT was used to measure cusp free margin length and geometric height. Agreement between CT-derived and intraoperative measurements was assessed using Bland-Altman analysis and intraclass correlation coefficients (ICCs). An exploratory analysis evaluated whether CT-derived cusp asymmetry predicted the need for intraoperative cusp plication. RESULTS: =0.06). Postoperative echocardiography demonstrated none-to-mild aortic insufficiency in 96.9% of patients. CONCLUSION: Preoperative CT demonstrated good agreement with intraoperative measurements for cusp free margin length in tricuspid valves, although the absolute limits of agreement were wide. CT-based quantification of cusp asymmetry may provide additional information for preoperative surgical planning; however, its association with intraoperative cusp plication remains exploratory and requires validation in larger studies. CLINICAL RESEARCH INFORMATION SERVICE (CRIS) REGISTRATION NUMBER: KCT0006180.
DOI: 10.3349/ymj.2026.0540
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $700
OpenAlex ID: W7210285095
FWCI:
Cites: 15
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Related to: 10