PMC:6580293 / 5944-7906 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6580293","sourcedb":"PMC","sourceid":"6580293","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6580293","text":"Heart evaluation\nWe followed a systematic approach, whereby each heart was inspected and measured externally followed by internal examination (S.M.K.) according to a predefined protocol (Supplementary Material, Table S1). The degree of aortic override was measured using 3 independent techniques. Firstly, the ‘leaflet proportion method’, adapted from Winn et al. [13], involved dividing each aortic valve leaflet into quarters and measuring the proportion of the aortic valve leaflets lying in the right ventricular cavity. Secondly, a ‘qualitative method’ for assessment of the percentage of aortic override involved visual inspection of the specimen by trained (A.C.) and expert (R.H.A.) morphologists. Thirdly, we introduce a novel ‘linear method’ to measure the percentage of aorta override based on the proportion of the circumference of the aortic root relative to the tangent produced by the ventricular septal crest that is supported by left ventricular structures (Fig. 1). As long as the majority of the circumference of the root is supported by left ventricular structures, the aorta is deemed to be committed to the left ventricle [14]. The left ventricular component was measured because of the way most hearts were dissected, with the tricuspid valve obstructing our view of the aortic root when assessing from the right ventricle. We compared the variability of these 3 techniques for quantifying aortic overriding, as there is currently no consensus in the literature on how best to measure this parameter.\nFigure 1: Linear method for the measurement of aortic override, as viewed from the left ventricle. The crest of the muscular ventricular septum was taken as the boundary for the aortic leaflets supported by the ventricular structures (red stars). The proportion of the circumference of the aortic root supported by the left ventricle is the sum of the red dashed lines and that supported by the right ventricle is the yellow dashed 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