The RAV morphology
Results are presented in Table 1. In 67.0% of specimens, the RAV had a 3-leaflet configuration. In the remaining 33.0% of hearts, the RAV had four leaflets (Figure 2). Valves with four leaflets had significantly larger perimeters than those with three leaflets (119.2 ± 11.1 vs. 109.3 ± 11.3 mm, p = 0.001). There was a correlation between the perimeter of the valve and the donors’ BMI in 3-leaflet heart valves (r=0.31, p < 0.001), but no such association was present in the 4-leaflet configuration. In hearts with a 3-leaflet configuration, the lengths of the superior leaflet and of the septal leaflet were similar, whereas the length of the mural leaflet was about twice as short (Table 1, p > 0.05). The same trends were noted in 4-leaflet heart valves (Table 1, p > 0.05). Interestingly, the individual leaflet height did not differ much within the same valve configuration (Table 1, p > 0.05). When present, the inferior leaflet was comparable in size to the mural leaflet (both in length and in height) (Table 1, p > 0.05). Significant differences in leaflet size were observed between the two valve configurations (Table 1). The superior leaflet had the least variability, and its length and height were comparable in 3- and 4-leaflet valves. Meanwhile, the septal and mural leaflets were both significantly shorter and higher in the 4-leaflet RAVs (Table 1).
Commissure lengths varied considerably within the 3-leaflet heart valves. The muro-septal commissure was substantially larger than the two remaining commissures (Table 1, p < 0.001). Such length disparities were not observed in the 4-leaflet configuration, where all four commissures had comparable lengths (Table 1, p > 0.05). Furthermore, the supero-mural commissure was significantly longer in the 3-leaflet heart valve when compared to the 4-leaflet heart valve (9.9 ± 4.0 vs. 7.5 ± 2.2 mm, p < 0.001).
Age and sex variables did not influence RAV configuration, leaflet size or commissure length.