主动脉根部外科解剖及其与毗邻结构关系

目的：测量主动脉根部不同高度的口径大小，并观察主动脉窦与邻近结构的关系。方法：用30例正常成人甲醛固定心脏标本，测量主动脉根部不同高度的口径和主动脉瓣的大小，观察主动脉窦与邻近结构的关系。结果：（1）主动脉窦中部（Sinus)＞主动脉窦管结合部上1cm(STJ1)＞主动脉窦管结合处（STJ0）＞主动脉瓣环基底（Base）。经方差分析检验，P＜0．05，说明主动脉根部4个高度口径大小的差别具统计学意义。（2）主动脉瓣的瓣高、瓣附着缘长和瓣游离缘长的测量结果显示。（3）二尖瓣前瓣中轴线与主动脉窦的关系显示，二尖瓣前瓣中轴线86．6％位于左冠状动脉窦与无冠状动脉窦之间。（4）右心房主动脉隆凸与主动脉窦的关系显示，右心房主动脉隆凸由无冠状动脉窦形成者占73．3％，由无冠状动脉窦和右冠状动脉窦共同形成者占26．7％。（5）左、右肺动脉瓣交界点与主动脉窦的关系显示，左、右肺动脉瓣交界点对向左、右冠状动脉窦之间者占80％。结论：测量结果有助于心外科手术的开展。

Surgical anatomy of the aortic root and its neighbouring structure relationships

Objective: To measure the size of the four aortic root levels and observe the neighbouring structure relationship of the aortic sinuses. Methods: 30 normal adult fixed heart specimens were studied. The dimensions of the four aortic root levels were measured and the neighbouring structure relationship of the aortic sinuses was observed. Results: (1) The dimensions of the four aortic root levels were obtained as follows, sinus>STJ_1>STJ_0>base (P<0.05). (2) The dimensions of the aortic valve leaflets were measured. The right coronary leaflet was larger than those of the left coronary were and noncoronary leaflets were. However, there was no statistically significance (P>0.05). (3) The relationships between middle axis of the anterior valve of the bicuspid valve and the aortic sinuses were observed. The middle axis of the anterior valve was located between the left coronary sinus and the noncoronary sinus in 26(86.6%). (4) The relationship between the aortic prominence of the right atrium and the aortic sinuses was observed. The aortic prominence was formed by noncoronary sinus in 22 (73.3%). (5) The relationship between the middle point of the right and left pulmonary valves and the aortic sinuses was observed. The middle point of right and left pulmonary valves faced to the point between the right and left aortic sinuses in 24 (80%). Conclusion: The measurement dimensions at four aortic root levels is as follows, sinus>STJ_1>STJ_0>base (P<0.05). The difference sizes of the three aortic valve leaflets are of no statistically significance (P>0.05).