Clinical anatomy of the aortic root.

tricular structures, form the centrepiece of the heart. All chambers of the heart are related directly to the valve, and its leaflets are incorporated directly into the cardiac skeleton. As such, the valve is the focus for the echocardiographer. Yet still the precise structure of its component parts remains controversial, with persisting disagreements relating largely to the enigmatic “annulus”. Indeed, it is diYcult to find an unequivocal definition of the annulus, a structure appearing most frequently in the context of cardiac surgery. This review describes the arrangement of the aortic root in terms of the attachment of the aortic valvar leaflets, and their relations to the aorta and its ventricular support. Recognising that these parts will still be considered to represent an annulus, I will try to show that the ring like structure thus described has considerable length, encompassing the entirety of the semilunar attachments of the leaflets. It is the recognition of the relation of these attachments to the anatomic and haemodynamic ventriculo-arterial junctions which is the key to understanding.