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The Annals of Thoracic Surgery, Vol 42, 434-440, Copyright © 1986 by The Society of Thoracic Surgeons
MJ Thubrikar, SP Nolan, J Aouad and JD Deck
A knowledge of the behavior of the aortic valve sinuses is necessary to the
understanding of stress sharing between the sinuses and the leaflets.
Radiopaque markers were placed on the sinuses and the leaflets of dogs
during cardiopulmonary bypass, and the movement of the markers was studied
using fluoroscopy. The center of the sinus moved radially during each
cardiac cycle, but in an inconsistent manner. The sinus was under a dual
influence: the passive influence of aortic pressure and the active
influence of myocardial contraction. The longitudinal curvature of the
sinus showed no dimensional change, whereas the radius of the
circumferential curvature decreased by 15.7% from systole to diastole. In
diastole, the stress in the sinus was 6.1 g/mm2 and was 24.3 g/mm2
circumferentially and 12.1 g/mm2 radially in the leaflet. Histologically,
the main stress-bearing component of the leaflet was made up of thick,
dense, collagenous fibers oriented circumferentially. These fibers curved
into the sinus wall instead of inserting straight into the aortic wall,
thereby suggesting that the high stress in the leaflet is shared with the
sinus and that continuity of the circumferential stress exists between the
leaflet and the sinus. The leaflet does not pull inwardly on the aortic
wall. In diastole, the sinus adapts to the new stress conditions in the
leaflet by reducing its radius of circumferential curvature. This stress
sharing is important for the longevity of the aortic valve.
ARTICLES
Stress sharing between the sinus and leaflets of canine aortic valve
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