Anatomy of the Aortic Valve

Abstract

The earliest documented interest in the anatomy of the aortic valvar complex stems from the Renaissance, with the description and drawings by Leonardo da Vinci (1513). Today, the need for accurate knowledge of the aortic valvar complex is imperative, especially for percutaneous therapies of the aortic valve. The aortic valve should be considered within the wider context of its anatomical and functional unit, namely, the aortic root. The latter is the connection between the left ventricle and the ascending aorta, and is located on the right, posteriorly to the subpulmonary infundibulum; its posterior margin is wedged between the mitral valve orifice and the muscular portion of the interventricular septum. The aortic root goes from the basal plane where the aortic valve leaflets enter the left ventricle to the peripheral point where they enter the sinotubular junction. About two-thirds of the circumference of the lower part of the aortic root are connected to the muscular portion of the interventricular septum. The remaining one-third is in continuity with the aortic leaflet of the mitral valve. Its components include the annulus, valve leaflets, commissures, sinuses of Valsalva, sinotubular junction, and interleaflet triangles.